The Relationship Between Serum Bilirubin Level And Severity Of Coronary Atherosclerotic Heart Disease

Objective: To study the relationship between serum bilirubin level and severity of coronary atherosclerosis.Methods: We selected 301 patients who were hospitalized in the Department of Cardiology of our hospital from December 2018 to September 2020 with coronary arteriography(CAG)as the research objects.According to the CAG results,they were divided into the coronary heart disease group according to whether they had coronary heart disease or not.There were 118 cases in the non-coronary heart disease group(control group);in the coronary heart disease group,there were 50 patients with single-vessel disease,70 patients with double-vessel disease,and 63 patients with multiple-vessel disease.According to Gensini score,the diseased blood vessels of patients with confirmed coronary heart disease were scored,and the coronary heart disease group was divided into low group(<33 points),middle group(33-64 points),and high group(>64 points).Collect serum bilirubin and its related clinical and biochemical indicators,compare total bilirubin(Ttotal Bilirubin,TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL)and The relationship between other biochemical indicators and the degree of coronary artery stenosis,and its correlation analysis.Results:(1)The TBIL,DBIL and IBIL of the coronary heart disease group were lower than those of the control group,and the difference was statistically significant(p<0.05).(2)The levels of TBIL,DBIL and IBIL decreased significantly as the Gensini score of patients with coronary heart disease increased or the number of lesions involved increased,and the difference was statistically significant(p<0.05).(3)Logistic regression analysis showed that after adjusting for high-risk factors of coronary heart disease such as smoking,diabetes,hypertension,and blood lipids,it was found that TBIL,DBIL,and IBIL were still protective factors for coronary artery disease,and Gensini score increased or Protective factors for the increase in the number of diseased coronary arteries.(4)Spearman correlation analysis of bilirubin level and Gensini score showed: TBIL level(r=-0.567,p<0.05),DBIL(r=-0.314,p<0.05)level and IBIL level(r=-0.499),P<0.05)were negatively correlated with the Gensini score of patients with coronary heart disease.(5)The ROC curve results show that the area under the ROC curve of DBIL level is 0.89,the area under the curve of TBIL level is 0.79,and the area under the curve of IBIL level is 0.65,indicating that the level of bilirubin has a higher prediction of the severity of coronary artery disease.value.Conclusion: The serum bilirubin level of patients in the coronary heart disease group was significantly lower than that of the normal control group,and in patients with coronary heart disease,we found that the bilirubin concentration is closely related to the severity of coronary heart disease,and the decrease in serum bilirubin concentration indicates severe coronary stenosis.The level of bilirubin decreased as the Gensini score increased or the number of vascular diseased branches increased.Therefore,bilirubin can be used as a biomarker for early diagnosis and risk stratification of coronary heart disease in clinical practice.