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Initial Total Bilirubin and Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention With Drug-Eluting Stents.

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Author(s)
Sang-Ryul Chung, MDTae-Hyun Yang, MDHo-Cheol Shin, MDHan-Young Jin, MDJeong-Sook Seo, MDJae-Sik Jang, MDDae-Kyeong Kim, MDDong-Soo Kim, MDGwang-Won SeoPil-Sang SongDong-Kie KimKi-Hun KimSang-Hoon SeolDoo-Il KimYun-Kyeong ChoHyuk-Joon YoonChang-Wook NamSeung-Ho HurUng KimJong-Seon ParkYoung-Jo Kim
Keimyung Author(s)
Cho, Yun KyeongYoon, Hyuck JunNam, Chang WookHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circulation Journal.
Issued Date
2016
Volume
80
Issue
6
Keyword
BilirubinDrug-eluting stentPercutaneous coronary interventionST-segment elevation myocardial infarction
Abstract
Background: Total bilirubin (TB) concentration is inversely associated with stable coronary artery disease, but there
have been few studies on initial TB in patients with ST-segment elevation myocardial infarction (STEMI).
Methods and Results: A total of 1,111 consecutive patients with STEMI undergoing primary percutaneous coronary
intervention (PCI) with drug-eluting stents (DES) were divided into a high TB group (n=295) and a low TB group
(n=816) according to the optimal cut-off 0.79 mg/dl. The high TB group had a higher rate of in-hospital major adverse
cardiac events (MACE), a composite of cardiac death, non-fatal MI, and definite/probable stent thrombosis (14.2%
vs. 4.2%, P<0.001) and cardiac death (13.9% vs. 3.9%, P<0.001) compared with the low TB group. The 30-day
MACE-free survival rate was also significantly different between the groups (P<0.001, log-rank test). On multivariate
Cox regression, initial high TB was a significant predictor of in-hospital MACE (HR, 2.69; 95% CI: 1.67–4.34,
P=0.010) and of cardiac death (HR 2.72, 95% CI: 1.67–4.44, P=0.012). Adding initial TB to TIMI risk score significantly
improved prediction for in-hospital MACE according to net reclassification improvement (NRI=5.2%, P=0.040)
and integrated discrimination improvement (IDI=0.027, P=0.006).
Conclusions: Initial TB is a powerful prognostic marker, and inclusion of this can improve prediction of in-hospital
MACE in patients with STEMI undergoing primary PCI with DES.
Keimyung Author(s)(Kor)
조윤경
윤혁준
남창욱
허승호
Publisher
School of Medicine
Citation
Sang-Ryul Chung, MD et al. (2016). Initial Total Bilirubin and Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention With Drug-Eluting Stents. Circulation Journal., 80(6), 1437–1444. doi: 10.1253/circj.CJ-15-1397
Type
Article
ISSN
1346-9843
DOI
10.1253/circj.CJ-15-1397
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33221
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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