The Clinical Relevant Analysis Of Serum Bilirubin And Coronary Atherosclerotic Heart Disease

Objective:The purpose of this study is to explore the correlation between serum bilirubin and the degree of atherosclerotic lesions,the clinical classification of coronary atherosclerotic heart disease, and if the serum bilirubin is independent of coronary atherosclerotic heart disease protective prediction factors.Method:From October 2014 to October 2015,463 cases of the first hospital of Jilin University Bethune Department of Cardiology operation patients underwent coronary angiography as the object of study.According to the results of coronary artery angiography were divided into coronary heart disease(CHD) group of 365 cases and normal control group of 98 case,CHD group was divided into 1 vessel disease, 2 vessel disease and multiple vessel disease group.CHD group was also divided into acute ST segment elevation myocardial infarction(STEMI) group, non ST segment elevation acute myocardial infarction(NSTEMI) group,unstable angina pectoris(UAP) group and stable angina pectoris(SAP) group based on the history.Results:(1) The difference of CHD group and the control group was statistically significant(P<0.05)in smoking,hypertension,diabetes,NLR,total bilirubin,indirect bilirubin,direct bilirubin,CTn I,LDL-C;(2) CHD group than in the control group, total bilirubin,indirect bilirubin,direct bilirubin was significantly decreased, and LDL-C,NLR was significantly increased.The number of vascular lesions in different subgroups,total bilirubin,indirect bilirubin,direct bilirubin value decreased with the number of vascular lesions(P<0.05),and LDL-C,NLR value increased with the number of vascular lesions(P<0.05).(3)The clinical types and clinical data were compared between the 4 groups:the results showed that total bilirubin,indirect bilirubin and direct bilirubin in STEMI group and NSTEMI group was lower than SAP group and UAP group, total bilirubin in UAP group was lower than the SAP group(P<0.05),and the rest of groups are no statistically significant difference.On the contrary,LDL-C and NLR in STEMI group and NSTEMI group was higher than SAP group and UAP group, UAP group was higher than the SAP group(P<0.05).,and STEMI group and NSTEMI group was no statistically significant difference.(4)Total bilirubin,indirect bilirubin, direct bilirubin were dominant linear negative correlation with Gensini score(r=-0.527,P<0.01)(r=-0.571,P<0.01)(r=-0.386,P<0.01),and LDL-C,NLR were significantly positive correlated with Gensini score( r= 0.505,P<0.01)(r= 0.539,P<0.01).Total bilirubin,indirect bilirubin, direct bilirubin were negatively correlated with LDL-C and NLR(r=-0.377,P<0.01)(r=-0.409,P<0.01)(r=-0.307,P<0.01)(r=-0.351,P<0.01)(r=-0.304,P<0.01)(r=-0.283,P<0.01).(5)Multivariate CHD regression analysis of risk factors of logistic:the results showed that smoking, NLR,LDL-C, triglycerides were an independent risk factor for coronary heart disease, but total bilirubin,indirect bilirubin were an independent protective factor for coronary heart disease.Conclusion: 1.Serum bilirubin and coronary vasculopathy count,Gensini score,the severity of coronary heart disease(the clinical classification of coronary heart disease) were negatively correlated, indicating that serum bilirubin may react the severity of coronary artery disease and coronary plaques stability. 2.Logistic analysis showed that the decline of total bilirubin and indirect bilirubin is an independent predictor of coronary heart disease after adjusting for other factors. 3.The negatively correlation of serum Bilirubin and inflammatory marker NLR、LDL-C showed that chronic inflammation may be related to the bilirubin.