Correlation Between The Severity Of Coronary Artery Disease And Serum Bilirubin Level,Inflammatory Indexes

Objective:The relationship between serum total bilirubin level,various inflammatory indexes and the severity of coronary artery disease was preliminarily discussed,and a new risk factor for coronary artery stenosis was found for clinical diagnosis.Evaluation and treatment of coronary heart disease provide a possible new thinking.Methods:In this study,the coronary angiography data of 238 inpatients were retrospectively analyzed.Coronary angiography was divided into control group(163cases)and CHD group(75 cases).The data of sex,age,smoking history,history of hypertension,history of diabetes were collected,the number of coronary lesion in CHD group was recorded,and the coronary lesion score(CSS)was calculated by Gensini score method.The fasting serum total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),total cholesterol(CHO),triglyceride(TG)were measured.High density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),urea urae(UREA),creatinine creatinine(CREA),uric acid(URCA).Fasting blood glucose(FBG),neutrophil to lymphocyte ratio(NLR),mean RBC volume distribution width variation coefficient(RDW-CV),platelets(PLT).Left ventricular ejection fraction(LVEF),et al.The levels of risk factors,inflammatory indexes and cardiac function were compared between CHD group and control group.According to the quartile of Gensini score,the patients in CHD group were divided into four groups: one vessel lesion,two vessel lesion and three vessel disease according to the number of coronary artery lesion.The levels of risk factors,inflammatory indexes and cardiac function were compared among the groups,and the correlation between CSS and risk factors was analyzed by Spearman correlation analysis.Univariate Logistic regression analysis was used to determine the relationship between risk factors and coronary heart disease.Results:1.CHD group TBIL,IBIL,LVEF were significantly lower than control group(P<0.05),and age,LDL-C,UREA,CREA,FBG,NLR,RDW-CV levels were higher than control group(P<0.05).2.From low to high Gensini score of four percentile after grouping the patientswith TBIL,IBIL,CHO,LDL-C,FBG,NLR,LVEF in different groups of Gensini score had significant difference between with coronary score increased.TBIL,IBIL,CHO,LDL-C,LVEF decreased,FBG,NLR increased(P<0.05).3.After grouping according to the number of coronary lesion branches,with the increase of the number of coronary artery lesion branches,the level of TBIL,LVEF decreased and NLR increased,and there was significant difference among different coronary lesion groups(P<0.05).4.Spearman correlation analysis showed that there was a significant positive correlation between the severity of coronary artery lesion and the age,CREA,FBG,NLR,RDW-CV,PLT(R values were 0.187 and 0.208 and 0.163 and 0.306 and 0.135 and 0.179,respectively,P<0.05),and TBIL,IBIL,LVEF was negatively correlated(R values were-0.151 and-0.177 and 0.352,respectively,P<0.05).5.Multivariate Logistic regression analysis showed that the risk of coronary heart disease increased with the decrease of total bilirubin level(OR=0.902,95%CI0.853~0.954,P<0.001).Conclusions:1.Serum bilirubin level was negatively correlated with the severity of coronary atherosclerosis,and low bilirubin level may be a new risk factor for coronary heart disease.2.There was a positive correlation between the severity of coronary artery disease and indirect inflammation,including NLR and RDW.3.The Left ventricular ejection fraction(LVEF)was negatively correlated with the severity of coronary artery disease.