Key result
High serum bilirubin after primary PCI is linked to increased in-hospital MACE and cardiac mortality.
Why the study?
Serum bilirubin increases acutely after STEMI and PCI, peaking at 21 h, motivating investigation into its association with patient prognosis after primary PCI.
Observational (n=90)
Answers are grounded in this paper and cite their sources.
Should not yet change risk stratification post-PCI; leaves open whether bilirubin improves MACE prediction in STEMI.
Background Serum bilirubin (SB) increases acutely after ST segment elevation myocardial infarction (STEMI)/percutaneous coronary intervention (PCI), peaking at 21 h after the intervention.Aim The aim of this study is to investigate the association of SB levels with the prognosis of STEMI patients after 1ry PCI.Patients and methods This study was carried out on 90 patients admitted with STEMI and treated with 1ry PCI and were divided into three equal groups: group I included patients with high SB levels (≥0.7 mg/dl), group II included patients with intermediate SB levels (0.49–0.7 mg/dl) and group III included patients with low SB levels (≤0.49 mg/dl). Comparison of clinical results was performed in terms of major adverse cardiac events (MACE) during hospital admission.Results Patients with high SB had higher Killip class II–IV, higher hemoglobin and white blood cell count, lower HDL levels, lower ejection fraction (EF) and higher rate of death and congestive heart failure. No significant difference was found in age, sex, family history of coronary artery disease (CAD), history of HTN, diabetes mellitus or smoking, dyslipidemia, symptoms duration, time to reperfusion, random blood sugar on admission, STEMI location, infarction-related artery, number of diseased vessels, type of intervention, Thrombolysis in Myocardial Infarction (TIMI) flow, serum triglycerides and LDL level, serum creatinine and Creatinine Kinase - MB (CK-MB) level on admission, number of patients undergoing reinfection and target vessel revascularization. High SB levels predicted the overall MACE following STEMI.Conclusion High SB was accompanied by in-hospital cardiac mortality, advanced heart failure and MACE after 1ry PCI in STEMI patients.
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Elmohr et al. (2020) conducted an observational in ST segment elevation myocardial infarction (STEMI) (n=90). High serum bilirubin levels (≥0.7 mg/dl) vs. Intermediate (0.49–0.7 mg/dl) and low (≤0.49 mg/dl) serum bilirubin levels was evaluated on In-hospital major adverse cardiac events (MACE). High serum bilirubin levels (≥0.7 mg/dl) after primary PCI in 90 STEMI patients predicted in-hospital MACE, cardiac mortality, and advanced heart failure.
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