PMID- 37371887 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230701 IS - 2076-3921 (Print) IS - 2076-3921 (Electronic) IS - 2076-3921 (Linking) VI - 12 IP - 6 DP - 2023 May 26 TI - Total Bilirubin Yields Prognostic Information Following a Myocardial Infarction in the Elderly. LID - 10.3390/antiox12061157 [doi] LID - 1157 AB - Total bilirubin consists of an unconjugated form, solubilized by its binding to albumin, and a conjugated form representing a minor part of the circulating bilirubin. As total bilirubin in physiological concentrations is a powerful antioxidant, its concentration gradient may reflect the health status of an individual, and serve as a prognostic indicator of outcome in primary and secondary cardiovascular disease prevention. The aim of this study was to assess the association between total bilirubin and incident cardiovascular events following a myocardial infarction. Total bilirubin in serum was measured at baseline 2-8 weeks after hospitalization for an MI in 881 patients, aged 70 to 82 years, included in the OMEMI (Omega-3 Fatty acids in Elderly with Myocardial Infarction) study, where patients were followed-up for up to 2 years. The first major adverse clinical event (MACE) was the primary endpoint and consisted of nonfatal MI, unscheduled coronary revascularization, stroke, hospitalization for heart failure or all-cause death. As total bilirubin was non-normally distributed, log-transformed values and quartiles of bilirubin were analyzed using Cox regression models. The median (Q1, and Q3) baseline concentration of bilirubin was 11 (9, and 14) micromol/L, and higher log-transformed concentrations were associated with male sex, lower New York Heart Association (NYHA) class and non-smoking. MACE occurred in 177 (20.1%) patients during the follow-up. Higher concentrations of bilirubin were associated with a lower risk of MACE: HR 0.67 (95%CI 0.47-0.97) per log-unit increase, p = 0.032. Patients in the lowest quartile of bilirubin (<9 micromol/L) had the highest risk with HR 1.61 (95%CI 1.19-2.18), p = 0.002, compared to quartiles 2-4. This association remained significant even after adjusting for age, sex, body mass index (BMI), smoking status, NYHA class and treatment allocation: HR 1.52 (1.21-2.09), p = 0.009. Low concentrations of bilirubin (<9 micromol/L) are associated with increased nonfatal cardiovascular events or death in elderly patients with a recent myocardial infarction. FAU - Nilsen, Dennis Winston T AU - Nilsen DWT AUID- ORCID: 0000-0001-6142-6863 AD - Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway. AD - Department of Clinical Science, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway. FAU - Myhre, Peder Langeland AU - Myhre PL AUID- ORCID: 0000-0002-5871-1804 AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Department of Cardiology, Division of Medicine, Akershus University Hospital, 1474 Lorenskog, Norway. FAU - Solheim, Svein AU - Solheim S AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ulleval, 0450 Oslo, Norway. FAU - Tveit, Sjur Hansen AU - Tveit SH AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Department of Cardiology, Division of Medicine, Akershus University Hospital, 1474 Lorenskog, Norway. FAU - Kalstad, Are Annesonn AU - Kalstad AA AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ulleval, 0450 Oslo, Norway. FAU - Laake, Kristian AU - Laake K AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ulleval, 0450 Oslo, Norway. FAU - Tveit, Arnljot AU - Tveit A AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Department of Medical Research, Baerum Hospital, Vestre Viken Hospital Trust, 1346 Gjettum, Norway. FAU - Seljeflot, Ingebjorg AU - Seljeflot I AUID- ORCID: 0000-0003-4071-3358 AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway. AD - Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ulleval, 0450 Oslo, Norway. LA - eng GR - NA/The work was supported by unrestricted grants from the Stein Erik Hagen Foundation for Clinical Heart Research, Oslo, Norway, the Olav Thons Foundation, Oslo, Norway and the Tom Wilhelmsen Foundation, Oslo, Norway./ PT - Journal Article DEP - 20230526 PL - Switzerland TA - Antioxidants (Basel) JT - Antioxidants (Basel, Switzerland) JID - 101668981 PMC - PMC10295173 OTO - NOTNLM OT - aged OT - bilirubin OT - myocardial infarction OT - prognosis OT - secondary prevention COIS- The authors declare no conflict of interest. EDAT- 2023/06/28 06:42 MHDA- 2023/06/28 06:43 PMCR- 2023/05/26 CRDT- 2023/06/28 01:09 PHST- 2023/03/27 00:00 [received] PHST- 2023/05/07 00:00 [revised] PHST- 2023/05/24 00:00 [accepted] PHST- 2023/06/28 06:43 [medline] PHST- 2023/06/28 06:42 [pubmed] PHST- 2023/06/28 01:09 [entrez] PHST- 2023/05/26 00:00 [pmc-release] AID - antiox12061157 [pii] AID - antioxidants-12-01157 [pii] AID - 10.3390/antiox12061157 [doi] PST - epublish SO - Antioxidants (Basel). 2023 May 26;12(6):1157. doi: 10.3390/antiox12061157.