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

Background: 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). Methods: 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. Results: 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. Conclusions: 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.