Abstract 16164: Total Bilirubin is an Independent Risk Factor for the Prevalence of Coronary Artery Disease in Men
Introduction: Total bilirubin has been shown to correlate inversely with cardiovascular disease in high risk patients, particularly men. In previous studies, cardiovascular disease has been assessed by cardiovascular events and mortality. Currently there is limited data correlating total bilirubin to angiographic demonstrated coronary artery disease (CAD) in men compared to women.
Hypothesis: We assessed the hypothesis that total bilirubin is an independent risk factor for angiographic demonstrated CAD only in men and not in women.
Methods: We analysed 565 men and 251 women of the BRAVEHEART cohort presenting for coronary angiography at our institution between October 2009 and March 2014. CAD was defined as the presence of at least 50% stenosis in the left anterior descending artery, left circumflex artery or right coronary artery, as demonstrated on coronary angiography. Multivariate logistic regression was undertaken for each sex to identify independent risk factors for CAD.
Results: CAD was present in 78% of men and 55% of women. In the male population, patients with CAD had a higher age (p<0.001), higher presence of hypercholesterolaemia (p<0.001) and diabetes (p<0.001), and a lower median total bilirubin level (12 vs. 13.5 μmol/L, p=0.0018) compared to patients without CAD. In the female population, patients with CAD had a higher age (p<0.001) as well as a higher presence of hypercholesterolaemia (p<0.001), hypertension (p= 0.0029) and positive cardiac family history (p=0.0048) compared to patients without CAD. There was no difference seen in the median total bilirubin level (10 vs. 10 μmol/L, p=0.3441) in females with and without CAD. On multivariate logistic regression, total bilirubin was an independent risk factor of CAD in the male population (odds ratio (OR), 0.95; 95% confidence interval (CI), 0.92-0.99; p=0.012) but not in the female population (OR, 1.00; 95% CI, 0.91-1.08; p=0.830).
Conclusions: In conclusion, total bilirubin was an independent risk factor for angiographic defined CAD only in men. Further studies are warranted to address the role for bilirubin as a predictor of CAD in high risk patients.
Author Disclosures: A. Nguyen: None. H. Adams: None. J. Gin: None. N. Yap: None. A.M. Wilson: None.
- © 2014 by American Heart Association, Inc.