Int J Med Sci 2022; 19(6):986-992. doi:10.7150/ijms.70833 This issue Cite

Research Paper

Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries

Guoqing Yin1, Lu Liu1, Abdul-Quddus Mohammed1, Rong Jiang1, Fuad A. Abdu1,✉, Wenliang Che1,2,✉

1. Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai, China
2. Department of Cardiology, Shanghai Tenth People's Hospital Chongming branch, Shanghai, China

Citation:
Yin G, Liu L, Mohammed AQ, Jiang R, Abdu FA, Che W. Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. Int J Med Sci 2022; 19(6):986-992. doi:10.7150/ijms.70833. https://www.medsci.org/v19p0986.htm
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Abstract

Graphic abstract

Background: Liver function parameters, particularly serum total bilirubin (TB), are closely associated with cardiovascular diseases. However, the impact of serum TB among patients with myocardial infarction and non-obstructive coronary (MINOCA) remains unknown. Our study investigated the relationship between serum TB at admission and long-term adverse clinical outcomes in MINOCA patients.

Methods: A total of 273 consecutive MINOCA patients were categorized into low and high serum TB groups based on the optimal cut-off of 0.9 mg/dl. The primary endpoint was major adverse cardiovascular events (MACE), including cardiac death, non-fatal MI, heart failure, and angina rehospitalization. Receiver-operating characteristic, Cox regression, and Kaplan-Meier analyses were used to evaluate the association of high serum TB with cardiovascular outcomes.

Results: High serum TB was found in 68 (24.9%) patients. The incidence of MACE was higher in the high TB group than in the low TB group after a median follow-up of 28 months (30.9 vs. 17.1%, P=0.015). The Kaplan-Meier curve analysis also indicated that patients in the high TB group had a higher risk of developing MACE (log-rank P=0.023). Cox regression analysis showed that high serum TB (>0.9mg/dl) significantly correlated with increased MACE risk (HR=1.90, 95%CI: 1.12-3.22, P=0.018). After adjusting for numerous clinical variables, the high serum TB remained significantly associated with an increased risk of MACE (HR=2.04, 95%CI: 1.05-3.94, P=0.034).

Conclusion: High initial serum TB (>0.9mg/dl) is a robust predictor of poor clinical outcomes among MINOCA patients. In clinical settings, assessing serum TB at admission may help identify high-risk patients presenting with MINOCA.

Keywords: MINOCA, Total bilirubin, clinical outcomes, Predictors


Citation styles

APA
Yin, G., Liu, L., Mohammed, A.Q., Jiang, R., Abdu, F.A., Che, W. (2022). Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. International Journal of Medical Sciences, 19(6), 986-992. https://doi.org/10.7150/ijms.70833.

ACS
Yin, G.; Liu, L.; Mohammed, A.Q.; Jiang, R.; Abdu, F.A.; Che, W. Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. Int. J. Med. Sci. 2022, 19 (6), 986-992. DOI: 10.7150/ijms.70833.

NLM
Yin G, Liu L, Mohammed AQ, Jiang R, Abdu FA, Che W. Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. Int J Med Sci 2022; 19(6):986-992. doi:10.7150/ijms.70833. https://www.medsci.org/v19p0986.htm

CSE
Yin G, Liu L, Mohammed AQ, Jiang R, Abdu FA, Che W. 2022. Association between Initial Serum Total Bilirubin and Clinical Outcome in Myocardial Infarction with Non-Obstructive Coronary Arteries. Int J Med Sci. 19(6):986-992.

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