Inverse relationship between serum total bilirubin levels and severity of disease in patients with stable coronary artery disease

Objective Many studies have shown that bilirubin may protect against atherosclerosis. In the present study, we assess the association between serum total bilirubin levels and the severity of coronary artery disease (CAD) assessed by angiography and the Syntax score. Methods Patients from our center, who visited the center for a coronary angiography, from January 2008 to January 2011, were eligible for this analysis. Serum bilirubin levels and other blood parameters in at least 12-h fasting states were determined. The patients were divided into tertiles according to their Syntax score. Results A total of 299 patients were registered for the study. The total bilirubin levels in the low Syntax score group were significantly higher than those of the other groups. After multiple logistic regression analysis, serum bilirubin levels (odds ratio = 0.155, 95% confidence interval, 0.039-0.62, P = 0.008) were identified as independent correlates of a high Syntax score. Conclusion Serum bilirubin levels were independently and inversely associated with the severity of disease in patients with stable CAD. Serum total bilirubin level may be useful as a marker of the severity of CAD. Coron Artery Dis 24:29-32 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Coronary Artery Disease 2013, 24:29-32