Key result
Lower total serum bilirubin levels are associated with coronary artery disease compared to matched controls.
Why the study?
Lower serum bilirubin levels have been associated with endothelial and microvascular dysfunction, but their relationship with coronary artery disease needed assessment.
Are lower serum bilirubin levels associated with the presence of coronary artery disease?
Cross-Sectional (n=200)
No
Are lower serum bilirubin levels associated with the presence of coronary artery disease?
Absolute Event Rate: 0.89% vs 1.23%
p-value: p=<0.001
Lower serum bilirubin levels are significantly associated with coronary artery disease and correlate with reduced ejection fraction, suggesting its potential as a predictive risk factor.
Lower bilirubin levels associated with CAD and reduced EF; hypothesis-generating for biomarker role, needs prospective validation.
Background: The protective effect of bilirubin relates to the antioxidant property of bilirubin, which prevents lipid oxidation, especially low-density lipoprotein (LDL), and inhibits free radical-induced dam-ages. Lower serum bilirubin level has been proven to be associated with endothelium and microvascular malfunction. The aim of the present study was to assess the association between serum bilirubin levels and coronary artery disease in comparison with controls without coronary artery disease.Methods: A cross-sectional study was conducted for a period of a one year in our medical college hospital. Patients with evidence of coronary artery disease for not more than 10 years of duration confirmed by ECG, ECHO and other previous case records were taken as cases. Controls were selected matched with age, gender and other co-morbid conditions. Total of 200 subjects were included in the study with 100 cases and 100 controls. General and systemic examination was conducted on all study subjects including laboratory investigations like complete blood count, renal function test, lipid profile, viral markers such as HBsAG, HCVIgM and liver function test which includes total bilirubin, direct and indirect, liver enzymes, albumin and globulin levels. A 12 lead ECG and a transthoracic echocardiogram was performed for all patients.Results: The various liver function test parameters were compared between the cases and controls it was found that the serum bilirubin levels which includes total bilirubin, direct bilirubin and indirect bilirubin was found to be lower among the case group compared to the control group and this difference was found to be statistically significant (p <0.05). A perfect linear correlation between the ejection fraction and serum bilirubin levels, as the ejection fraction decreases the serum bilirubin levels was also decreasing.Conclusions: This study showed a significant association between the reduced serum bilirubin levels and the occurrence of CAD; therefore, bilirubin level can serve as a predictive factor, together with other influential factors for identifying a person at risk of developing coronary artery disease.
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Jayanthi et al. (2018) conducted a cross-sectional in Coronary artery disease (n=200). Serum bilirubin levels vs. Controls without coronary artery disease was evaluated on Total serum bilirubin (p=<0.001). Total serum bilirubin levels were significantly lower in patients with coronary artery disease compared to matched controls (0.89 vs 1.23, p<0.001).
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