Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Rd, Shaanxi, Xi'an 710061, China.
Department of Medical Insurance, Xi'an Affiliated Hospital of the Shaanxi University of Chinese Medicine, China.
Cardiovasc Ther. 2023 Sep 5;2023:5532917. doi: 10.1155/2023/5532917. eCollection 2023.
Serum total bilirubin (STB) is recently more regarded as an antioxidant with vascular protective effects. However, we noticed that elevated STB appeared in unstable angina pectoris (UAP) patients with diffused coronary lesions. We aimed to explore STB's roles in UAP patients, which have not been reported by articles.
1120 UAP patients were retrospectively screened, and 296 patients were finally enrolled. They were grouped by Canadian Cardiovascular Society (CCS) angina grades. The synergy between PCI with TAXUS stent and cardiac surgery score (SYNTAX score) and corrected thrombolysis in myocardial infarction flow count (CTFC) were adopted to profile coronary features. The results showed that STB, mean platelet volume (MPV), hs-CRP, fasting blood glucose (FBG), red blood cell width (RDW), and CTFC elevated significantly in the CCS high-risk group. STB ( = 0.59, 95% CI: 0.39-0.74, < 0.01) and MPV ( = 0.86, 95% CI: 0.42-1.31, < 0.01) could indicate SYNTAX score changes for these patients. STB (≥21.7 mol/L) could even indicate a coronary slow flow condition (AUC: 0.88, 95% CI: 0.84-0.93, < 0.01). Moreover, UAP patients with elevated STB had a lower event-free survival rate by the Kaplan-Meier curve. STB ≥21.7 mol/L could reflect a poor coronary flow status and indicate 1-year poor outcomes for these patients (HR: 2.01, 95% CI: 1.06-3.84, < 0.01).
Elevated STB in UAP patients has a close relationship with changes in SYNTAX score. STB (over 21.7 mol/L) could even indicate a coronary slow flow condition and poor outcomes for the UAP patients.
血清总胆红素（STB）最近被认为是一种具有血管保护作用的抗氧化剂。然而，我们注意到不稳定型心绞痛（UAP）患者存在弥漫性冠状动脉病变时，其 STB 水平升高。我们旨在探讨 STB 在 UAP 患者中的作用，这方面的内容尚未有文献报道。
回顾性筛选了 1120 例 UAP 患者，最终纳入 296 例患者。根据加拿大心血管学会（CCS）心绞痛分级对患者进行分组。采用经皮冠状动脉介入治疗（PCI）联合紫杉醇支架和心脏手术评分（SYNTAX 评分）以及校正的心肌梗死溶栓血流分级（CTFC）来评估冠状动脉特征。结果显示，CCS 高危组的 STB、平均血小板体积（MPV）、高敏 C 反应蛋白（hs-CRP）、空腹血糖（FBG）、红细胞宽度（RDW）和 CTFC 显著升高。STB（ = 0.59，95%CI：0.39-0.74， < 0.01）和 MPV（ = 0.86，95%CI：0.42-1.31， < 0.01）可以反映这些患者的 SYNTAX 评分变化。STB（≥21.7μmol/L）甚至可以提示冠状动脉慢血流状态（AUC：0.88，95%CI：0.84-0.93， < 0.01）。此外，Kaplan-Meier 曲线显示，STB 升高的 UAP 患者无事件生存率较低。STB≥21.7μmol/L 可反映冠状动脉血流不良状态，并提示这些患者 1 年预后不良（HR：2.01，95%CI：1.06-3.84， < 0.01）。
UAP 患者 STB 升高与 SYNTAX 评分变化密切相关。STB（超过 21.7μmol/L）甚至可以提示冠状动脉慢血流状态和 UAP 患者预后不良。
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