We evaluated the association of total bilirubin with post-percutaneous coronary intervention (PCI) coronary blood flow and in-hospital major adverse cardiac events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. A total of 536 consecutive patients with STEMI (male 79%, mean age = 59.9 ± 12.6 years) admitted within 6 hours from symptom onset were enrolled. Patients were divided into 2 groups based on the thrombolysis in myocardial infarction (MI) flow grade. In-stent thrombosis, nonfatal MI, and in-hospital mortality were significantly higher in no-reflow group (P = .007, P = .002, and P < .001, respectively). On multivariate regression, the total bilirubin levels remained independent predictors of no-reflow (odds ratio [OR] 1.586, 95% confidence interval [CI] 1.02-2.47; P = .042) and in-hospital MACE (OR 1.399, 95% CI 1.053-1.857; P = .020). Serum bilirubin levels were independently associated with no-reflow and in-hospital MACE in patients with STEMI undergoing primary PCI.
KayaMGUyarelHAkpekM. Prognostic value of uric acid in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol. 2012;109(4):486–491.
2.
AkpekMKayaMGUyarelH. The association of serum uric acid levels on coronary flow in patients with STEMI undergoing primary PCI. Atherosclerosis. 2011;219(1):334–341.
3.
TopsakalRKayaMGKarakayaE. Relationship between no-reflow phenomenon and serotonin levels in patients with acute ST-elevation myocardial infarction who underwent primary percutaneous intervention. Anadolu Kardiyol Derg. 2010;10(3):253–259.
4.
ReffelmannTKlonerRA. The no-reflow phenomenon: a basic mechanism of myocardial ischemia and reperfusion. Basic Res Cardiol. 2006;101(5):359–372.
5.
SahinOAkpekMElcikD. Bilirubin levels and the burden of coronary atherosclerosis in patients with STEMI. Angiology. 2013;64(3):200–204.
6.
BreimerLHMikhailidisDP. Could carbon monoxide and bilirubin be friends as well as foes of the body?Scand J Clin Lab Invest. 2010;70(1):1–5.
7.
OkuharaKKisakaTOzonoR. Change in bilirubin level following acute myocardial infarction is an index for heme oxygenase activation. South Med J. 2010;103(9):876–881.
8.
TIMI Study Group. The thrombolysis in myocardial infarction (TIMI) trial. Phase I findings. N Engl J Med. 1985;312(14):932–936.
9.
AkpekMElcikDKalayN. The prognostic value of serum gamma glutamyl transferase activity on admission in patients with STEMI undergoing primary PCI. Angiology. 2012;63(8);579–585.
10.
KayaMGYalcinROkyayK. Potential role of plasma myeloperoxidase level in predicting long-term outcome of acute myocardial infarction. Tex Heart Inst J. 2012;39(4):500–506.
11.
AkpekMKayaMGLamYY. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with st-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol. 2012;110(5):621–627.
12.
The GUSTO Angiographic investigators. The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction. N Engl J Med. 1993;329(22):1615–1622.
13.
KayaMGArslanFAbaciAvan der HeijdenGTimurkaynakTCengelA. Myocardial blush grade: a predictor for major adverse cardiac events after primary PTCA with stent implantation for acute myocardial infarction. Acta Cardiol. 2007;62(5):445–451.
14.
ItoHMaruyamaAIwakuraK. Clinical implications of the ‘no reflow' phenomenon. A predictor of complications and left ventricular remodeling in reperfused anterior wall myocardial infarction. Circulation. 1996;93(2):223–228.
HuczekZKochmanJFilipiakKJ. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol. 2005;46(2):284–290.
17.
SerdarZSerdarAAltinAEryilmazUAlbayrakS. The relation between oxidant and antioxidant parameters and severity of acute coronary syndromes. Acta Cardiol. 2007;62(4):373–380.
18.
AmanvermezRAcarEGunayMBaydınAYardanTBekY. Hsp 70, hsCRP and oxidative stress in patients with acute coronary syndromes. Bosn J Basic Med Sci. 2012;12(2):102–107.
19.
NeuzilJStockerR. Free and albumin-bound bilirubin are efficient co-antioxidants for alpha-tocopherol, inhibiting plasma and low density lipoprotein lipid peroxidation. J Biol Chem. 1994;269(24):16712–16719.
20.
MayerM. Association of serum bilirubin concentration with risk of coronary artery disease. Clin Chem. 2000;46(11):1723–1727.
21.
NakayamaMTakahashiKKomaruT. Increased expression of heme oxygenase-1 and bilirubin accumulation in foam cells of rabbit atherosclerotic lesions. Arterioscler Thromb Vasc Biol. 2001;21(8):1373–1377.
22.
StockerR. Antioxidant activities of bile pigments. Antioxid Redox Signal. 2004;6(5):841–849.
23.
RigatoIOstrowJDTiribelliC. Bilirubin and the risk of common non-hepatic diseases. Trends Mol Med. 2005;11(6):277–283.
24.
WuTWWuJLiRKMickleDCareyD. Albumin-bound bilirubins protect human ventricular myocytes against oxyradical damage. Biochem Cell Biol. 1991;69(10-11):683–688.
25.
YanoYOzonoROishiY. Genetic ablation of the transcription repressor Bach1 leads to myocardial protection against ischemia/reperfusion in mice. Genes Cells. 2006;11(7):791–803.
26.
MeloLGAgrawalRZhangL. Gene therapy strategy for long-term myocardial protection using adeno-associated virus-mediated delivery of heme oxygenase gene. Circulation. 2002;105(5):602–607.
27.
YetSFTianRLayneMD. Cardiac-specific expression of heme oxygenase-1 protects against ischemia and reperfusion injury in transgenic mice. Circ Res. 2001;89(2):168–173.
28.
GriendlingKKFitzGeraldGA. Oxidative stress and cardiovascular injury: part I: basic mechanisms and in vivo monitoring of ROS. Circulation. 2003;108(16):1912–1916.
29.
MinuzPFavaCLechiA. Lipid peroxidation, isoprostanes and vascular damage. Pharmacol Rep. 2006;58(suppl):57–68.
30.
MarcantoniEDi FrancescoLDovizioMBrunoAPatrignaniP. Novel insights into the vasoprotective role of heme oxygenase-1[published online February 22, 2012]. Int J Hypertens. 2012;2012:127910.
31.
EganKMLawsonJAFriesS. COX-2-derived prostacyclin confers atheroprotection on female mice. Science. 2004;306(5703):1954–1957.
32.
BreimerLHMikhailidisDP. Is bilirubin a marker of vascular disease and/or cancer and is it a potential therapeutic target?Curr Pharm Des. 2011;17(33):3644–3655.
