Prognostic Value Of Serum Bilirubin In STEMI Patients Complicated With Metabolic Syndrome

Objective: To evaluate the predictive value of bilirubin levels in short-term prognosis of acute ST-segment elevation myocardial infarction(STEMI)patients combined with metabolic syndrome(MS).Methods: This study included 537 patients who were admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2015 to October 2017 because of chest pain and diagnosed as STEMI.All patients were divided into high-risk group(335 cases with MS)and low-risk group(202cases without MS).We compared the general information and in-hospital mortality between two groups,multivariate logistic regression analysis was used to find indicators such as bilirubin that may affect the prognosis of STEMI.We Further observe the correlation between serum total bilirubin levels and in-hospital death in STEMI patients combined with MS.Results:(1)The serum total bilirubin level was lower in STEMI with MS group than STEMI without MetS group(P = 0.037).(2)STEMI with MS group has higher coronary stenosis than STEMI without MS group(P <0.05).(3)There was no significant correlation between total bilirubin levels and in-hospital death of STEMI in a univariate analysis,but further multivariate logistic regression analysis revealed that age,total bilirubin,and white blood cell levels were independently correlated with in-hospital death of STEMI combined with MS(P <0.001,P = 0.048,P <0.001).Serum total bilirubin was an independent predictor of in-hospital mortality of STEMI patients combined with MS(OR = 1.087;95%(CI 1.001 ~ 1.180;P = 0.048),while there was no that correlation in STEMI without MS group(OR = 1.056;95% CI 0.965 ~ 1.156;P =0.236).we followed STEMI with MS group for average 1065(418~1618)days and found no significant correlation between bilirubin levels and long-term outcomes.Conclusion:Serum total bilirubin level is an independent risk factor of in-hospital death in STEMI patients combined with MS after PPCI,and bilirubin can predict the short-term prognosisof STEMI patients with MS but not the long-term outcomes.