Gao Fan, Qiang Hua, Fan Xiao-Juan, Xue Qi, Bai Ling
Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.
Ther Clin Risk Manag. 2019 Jul 1;15:811-821. doi: 10.2147/TCRM.S203433. eCollection 2019.
Previous research findings on the association between serum total bilirubin (TB) and cardiovascular events varied with different study populations. Our objective was to clarify the association between serum TB at admission and long-term adverse outcomes in patients with acute coronary syndrome (ACS) and stable angina (SA) undergoing percutaneous coronary intervention (PCI). This prospective cohort study included 2,502 patients who underwent PCI. Information on the study population was obtained from the Dryad Digital Repository. The patients were divided into two groups: high (>0.60 mg/dL) and low TB groups (≤0.60 mg/dL) based on the optimal cutoff value achieved in the receiver operating characteristic curve analysis. The relationships between serum TB at admission and clinical outcomes after PCI were analyzed in multivariable logistic regression models and restricted cubic spline. In all patients undergoing PCI, TB>0.60 mg/dL was associated with major adverse cardiovascular events (MACE) and cardiovascular death during a 3-year follow-up. The odds ratio (95% confidence interval) was 1.60 (1.22-2.10) and 1.81 (1.22-2.70) for MACE and cardiovascular death, respectively. The association between TB and MACE was not altered by clinical presentation ( for interaction=0.949). In patients with ACS and SA undergoing PCI, elevated serum TB was associated with increased risk of MACE and cardiovascular death.
先前关于血清总胆红素（TB）与心血管事件之间关联的研究结果因研究人群不同而有所差异。我们的目的是阐明接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）和稳定型心绞痛（SA）患者入院时血清TB与长期不良结局之间的关联。这项前瞻性队列研究纳入了2502例接受PCI的患者。研究人群的信息来自Dryad数字资源库。根据受试者工作特征曲线分析得出的最佳截断值，将患者分为两组：高TB组（>0.60 mg/dL）和低TB组（≤0.60 mg/dL）。在多变量逻辑回归模型和受限立方样条分析中，分析了入院时血清TB与PCI后临床结局之间的关系。在所有接受PCI的患者中，TB>0.60 mg/dL与3年随访期间的主要不良心血管事件（MACE）和心血管死亡相关。MACE和心血管死亡的比值比（95%置信区间）分别为1.60（1.22 - 2.10）和1.81（1.22 - 2.70）。TB与MACE之间的关联不受临床表现的影响（交互作用P = 0.949）。在接受PCI的ACS和SA患者中，血清TB升高与MACE和心血管死亡风险增加相关。
