Association Between the Initial Total Bilirubin Level and the Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI

Clarification is needed as regards the relationship between the total bilirubin level and the outcome of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Between April 2015 and April 2016, consecutive patients with STEMI who underwent primary PCI were prospectively enrolled in a primary PCI registry. The patients’ demographics, initial total bilirubin levels, procedural characteristics, and in-hospital and 6 months’ major adverse cardiac events were assessed. A total of 95 patients who underwent primary PCI were enrolled in the study. The mean bilirubin level was 1.04 mg/dL with a standard deviation of 1.154. We evaluated the relationships between the median of the initial total bilirubin level, the thrombolysis in myocardial infarction (TIMI) flow grade after PCI and following PCI, 6 months’ follow-up complications, the amount of the peak troponin and CK-MB levels, the amount of mitral regurgitation, the ejection fraction, and electrocardiographic changes including ST resolution and the Q-wave formation after primary PCI. Except for the levels of troponin and CK-MB, there were no relationships between the initial total bilirubin level and the other end points. Recent studies have shown that the serum total bilirubin level is independently associated with short-term outcomes in patients with STEMI. We found a direct relationship between the total bilirubin level and the peak levels of troponin and CK-MB after primary PCI. This outcome is consistent with other studies; nonetheless, we found no such relationships vis-à-vis the other end points. This result may be due to our small patient population.