Serum total bilirubin and long-term outcome in patients undergoing percutaneous coronary intervention

Purpose: The purpose of this study was to investigate the associated between serum total bilirubin (STB) levels and long-term outcomes in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods: A total of 1,273 consecutive patients were enrolled. Patients were grouped according to their baseline STB levels: Group 1 (STB < 3.4 μmol/L), Group 2 (3.4 μmol/L ≤ STB ≤ 10.3 μmol/L), Group 3 (10.3 μmol/L < STB ≤ 17.1 μmol/L), and Group 4 (STB > 17.1 μmol/L) and the rate of major adverse cardiovascular events (MACE) was determined Results: A total of 1,152 patients were successfully followed up (90.5%) for a mean period of 30 ± 5 months, including 187 patients experiencing a major adverse cardiovascular event (MACE: death from any cause, myocardial infarction, repeat revascularization or readmission). The MACE rate in Groups 3 and 4 was lower than in Groups 1 and 2 (P < 0.01). After adjusted the confounding factors with Cox regression analysis, the MACE rates in Groups 2-4 were still lower than in Group 1 (Group 2, RR=0.293, 95% CI 0.167-0.517, P<0.01; Group 3, RR=0.142, 95% CI 0.065-0.312, P<0.01; Group 4, RR=0.134, 95% CI 0.071-0.252, P<0.01). The cumulative survival rates of Groups 3 and 4 were higher than that of Groups 1and 2 (P<0.01). Conclusions: High STB concentration is associated with lower MACE in patients with ACS after PCI.