Relationship Between Serum Bilirubin Level,Monocyte,Red Blood Cell Distribution Width And The Severity Of Coronary Artery Disease

BackgroundThe prevalence of coronary atherosclerotic heart disease(CHD)is increasing year by year,and the incidence is getting younger and younger.Serum bilirubin is the final product of heme metabolism.Many studies have shown that bilirubin can prevent atherosclerosis due to its antioxidant properties.Therefore,it is speculated that elevated serum bilirubin levels may reduce the risk of atherosclerosis.Recent studies have shown that monocyte participate in many pathophysiological pathways of CHD,such as lipid metabolism,angiogenesis,apoptosis,hypoxia,coagulation,etc.,and play an important role in the occurrence and development of CHD.The red blood cell distribution width(RDW)is a test item of blood routinely,which is mainly used for the diagnosis of anemia.According to foreign reports,RDW is closely related to cardiovascular disease,and it has important value in CHD risk and prognosis evaluation.However,there are few reports on the extent and severity of coronary atherosclerosis in RDW and CHD patients.ObjectiveThe aim of this study was to use Gensini score for the evaluation of the severity of coronary artery disease in patients undergoing coronary angiography,to investigate the relationship between Serum bilirubin level,Monocyte(Mon),red blood cell distribution width(RDW)and the severity of coronary artery disease.MethodsA total of 247 patients with suspected coronary atherosclerotic heart disease(CHD)in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to January 2017 were selected.The serum total bilirubin(TBi L),direct bilirubin(DBi L),indirect bilirubin(IBi L),Mon,RDW were detected.According to the results of coronary angiography,the Gensini score was used to classify the patients suspected of coronary artery disease.The patients who got 0 point was divided into normal group which include 43 cases and the patients who got 1 or more points were divided into coronary artery disease group which include 204 cases.Among the coronary artery disease group,the patients who got 1 to 19 points were classified as mild stenosis group which include 75 cases,20 to 39 points were divided into intermediate lesion group which include 46 cases,?40 points were divided into severe lesions group which include 83 cases.compare the differences of total bilirubin(TBi L),direct bilirubin(DBi L),indirect bilirubin(IBi L),Mon,RDW in the comparison of patients with different coronary artery disease.ResultsThe TBi L,DBi L,IBi L in group with coronary artery disease were significantly lower than those in normal group(P<0.01),and Mon and RDW were significantly higher than normal group(P<0.01).Compared with patients with mild and moderate coronary artery lesions,the coronary artery patients with severe disease had the lowest levels with TBi L,DBi L,IBi L(P<0.05),and had the highest levels with Mon,RDW(P<0.05)in Coronary lesion group.There was no significant difference in Mon and RDW between moderate group and mild group(P>0.05).The TBi L,DBi L,IBi L were significantly negatively correlated with Mon and RDW(r=-0.261,P=0.000;r=-0.252,P=0.000;r=-0.167,P=0.023);(r=-0.498,P=0.012;r=-0.482,P=0.000;r=-0.315,P=0.000);The Mon was positively correlated with RDW(r=0.333,P=0.000).The TBi L,DBi L,IBi L were significantly negatively correlated with Gensini score(r=-0.333,P=0.000;r=-0.356,P=0.0 01;r=-0.223,P=0.021).The Mon and RDW was positively correlated with Gensini score(r=0.432,P=0.000;r=0.508,P=0.000).ConclusionsTBi L,DBi L,IBi L Mon and RDW can be used as the risk factors for CHD,which has important reference value in predicting the occurrence of CHD and evaluating the severity of coronary artery disease.