Total Bilirubin Predicts In-Hospital Mortality in STEMI

For patients with STEMI undergoing PCI, in-hospital mortality is increased with high bilirubin

TUESDAY, Oct. 30 (HealthDay News) -- For patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), serum total bilirubin (TB) levels can be used to predict the risk of in-hospital mortality, according to a study published online Oct. 26 in The American Journal of Cardiology.

In an effort to examine the correlation between TB levels and in-hospital and long-term outcomes, Mehmet Gul, M.D., from the Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital in Turkey, and colleagues used data from 1,624 consecutive patients with STEMI who underwent primary PCI. After PCI, TB was measured and the population was stratified into tertiles, with the high TB group (450 patients) defined as a value >0.9 mg/dL and the low TB group (1,174 patients) defined as any value in the lower two tertiles (≤0.9 mg/dL).

The researchers found that the in-hospital mortality rate was significantly higher in the high TB group (4 percent) than the low TB group (1.5 percent). There was a significant correlation between high TB levels and the multivariable adjusted risk of in-hospital cardiovascular mortality (odds ratio, 3.24). TB >0.90 mg/dL was identified as an effective cut-off for in-hospital mortality in the receiver operating characteristic curve analysis (area under the curve, 0.66). There was no difference in long-term mortality between the high and low TB groups.

"From the findings of the present study, we suggest that TB is widely available to clinicians as a biochemistry parameter and a powerful prognostic factor for patients undergoing primary angioplasty for STEMI," the authors write. "It can be used for risk stratification in this patient population."

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