Serum Bilirubin as a Predictor of Coronary Artery Disease Severity in Patients Undergoing Primary Percutaneous Coronary Intervention

摘要

Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate the relationship of serum bilirubin level with the severity and complexity of coronary artery disease (CAD) in the patients undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: 70 patients with STEMI who were undergoing primary PCI were included in the study. All the patients included in the study were subjected to full routine investigations and standard coronary angiographic projections. Total bilirubin level was measured and the patients were divided into two groups. Group 1 was with serum TB (<1 mg/dl) and Group 2 was with serum TB (>1 mg/dl). Severity and complexity of coronary artery lesions will be assessed using Gensini score. Results: After PCI , the two studied groups were compared regarding the number of vessels affected by one and more than one vessel disease. Single vessel disease was frequent in Group 2 (71%) with significant p value (0.003). Cardiac enzymes (troponin I) was more in Group 1 (S. Bil < 1) with significant p value ( 0 .02) . Also (ALT, AST) were more in Group 1 (p value = 0.01). By comparing the 2 groups , there was a significant difference regarding (EF) between both which was less in Group 1 (S.TB < 1) than Group 2 (S.TB > 1), p value significance (0, 0001). Also GENSENI was more in Group 1 (S.TB < 1) than Group 2 (S.TB > 1) with mean (80.35 vs 34.71) and significant p value (0 . 0001). There was a highly significant negative correlation between serum bilirubin & GENSENI score (r = -0.762 , p value 0 . 0001). Regarding the incidence of complications, incidence was more in Group 1 (S.TB < 1) than in Group 2 (S.TB > 1) , which means a significant difference between both groups with significant p value (0.0001). There was a significant negative correlation between serum bilirubin & incidence of complications (R = -0.38, p value 0.001). Also , there was a significant negative correlation between GENSINI score, complication and bilirubin among both groups (r: -0.762-0.38) with p value (0.00010.001) respectively. Conclusion: In conclusion, our results suggested that the Serum Bilirubin level is inversely correlated with the severity of CAD. Also, the SB level is an independent predictor of cardiovascular events in CAD patients. Understandably, our fi ndings need further veri fi cation by large-scale, multicenter clinical trials in the future.