Association of total bilirubin levels with acute coronary syndrome and other risk factors: an observational study

Background: Acute coronary syndrome (ACS) refers to clinical symptoms pertaining to acute myocardial infarction. Bilirubin is an antioxidant that helps in removal of excessive heme. The aim of the study was to find the association of ACS and other risk factors for ACS with the total bilirubin levels in our setup.Methods: A cross sectional observational study was conducted on 100 cases attending the department of medicine in a Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, Maharashtra. Patients fitting the eligibility criteria were subjected to data collection which was done using pre-designed case record form. The case record form had details of demography, detailed clinical history, physical examination and relevant investigations.Results: The mean age of the cases was 55.64±10.23 years with male preponderance. Majority of the patients presented with chest pain (83%) followed by shortness of breath (65%) and nausea/vomiting (33%). There was moderate significant correlation between total bilirubin levels and LDL levels (r=0.703; p value<0.001) and There was mild significant correlation between total bilirubin levels and TGs (r=0.403, p value<0.001) Based on the median value of 0.48 as cut off, 33% had bilirubin levels more than 0.48. Presence of diabetes and hyperlipidemias had significant association with the total bilirubin levels.Conclusions: Nearly 1/3rd of the patients in our study had high bilirubin levels. Higher bilirubin levels correlated well with presence of diabetes and presence of hyperlipidemias. There was significant correlation between the serum LDL and TG levels with total bilirubin levels in the present study.