Features of serum bilirubin in non ST elevation acute coronary syndrome

Type of funding sources: None.

Even though, bilirubin is known to be an endogenous antioxidant, there is conflicting evidence whether level of serum bilirubin is associated with non-ST elevation acute coronary syndrome (NSTE ACS).

We aimed to assess the possible impact of bilirubin level non-ST elevation acute coronary syndrome.

128 patients with NSTEACS were enrolled in the study (Aged 38-75 years; mean age 56.2±16.85 years; male 53%). Patients were divided into two groups in terms of level of total bilirubin. Group I included 56 patients (total bilirubin was higher 19 mMol/L) and Group II 72 patients with NSTA ACS (total bilirubin was lower 19 mMol/L). Anthropometric, laboratory including serum total, direct, indirect bilirubin level and instrumental data were obtained at baseline while admission prior to percutaneous coronary intervention. Follow-up was conducted via telephone in six months. Statistical analysis were performed by STATA software.

Patients presenting with NSTE ACS having high level of bilirubin tended to have more severe course of the disease (62% vs. 53%, P<0.05), high level of high sensitive troponin level (55ng/mL vs. 43 ng/mLK, P=0.001), multi-vessel disease (35% vs. 21%, P=0.001) and high rate of new revascularization (82% vs. 65%, P=0.001) than those ones with lower level of total bilirubin. Patients with high level of total bilirubin at admission with NSTE ACS had worse outcomes both in 1 month (1.24; 1.12-1.75; CI 95%; P<0.05) and 6 months follow-up period than those NSTE ACS patients with lower bilirubin level at admission (1.512; 1.24-1.95; CI 95%; P<0.05).

Total serum bilirubin level seems to be an independent predictor for severity of the disease and adverse outcomes in patients with NSTE ACS.