Observational studyJournal of the American Heart Association2018
Bilirubin Is Inversely Associated With Cardiovascular Disease Among HIV-Positive and HIV-Negative Individuals in VACS (Veterans Aging Cohort Study).
Observational study in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 5 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Inflammatory Biomarkers Predicting Major Adverse Cardiovascular Events in People Living With HIV: A Systematic Review and Meta-Analysis.Journal of the International AIDS Society · 2026Pooled it
- Characterization and stratification of risk factors of stroke in people living with HIV: A theory-informed systematic review.BMC cardiovascular disorders · 2025Pooled it
- Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- The Nonlinear Relationship Between Total Bilirubin and Coronary Heart Disease: A Dose-Response Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- Is serum total bilirubin a predictor of prognosis in arteriosclerotic cardiovascular disease? A meta-analysis.Medicine · 2019Pooled it
- Bilirubin reduces mortality in sepsis models by inhibiting NOX2-mediated formation of neutrophil extracellular traps.Redox report : communications in free radical research · 2026Article
- A prediction model for the risk of developing HFpEF during hospitalization in patients with acute myocardial infarction.International journal of cardiology. Heart & vasculature · 2026Article
- Association between liver fibrosis scores and cardiovascular disease in elderly based on NHANES 1999-2018.Scientific reports · 2025Article
- Association of QTc prolongation with liver function test and complications in patients with cirrhosis: An observational study.Journal of family medicine and primary care · 2025Article
- The HELP-UnaG Fusion Protein as a Bilirubin Biosensor: From Theory to Mature Technological Development.Molecules (Basel, Switzerland) · 2025Review
- Association of total bilirubin and prognosis in disorders of consciousness.Scientific reports · 2024Article
- Identification of Chagas disease biomarkers using untargeted metabolomics.Scientific reports · 2024Article
- Bile Acids and Bilirubin Role in Oxidative Stress and Inflammation in Cardiovascular Diseases.Diseases (Basel, Switzerland) · 2024Review
- Predictive model and risk analysis for coronary heart disease in people living with HIV using machine learning.BMC medical informatics and decision making · 2024Article
- Prevention and treatment of cardiovascular disease in HIV: practical insights in an evolving field.Topics in antiviral medicine · 2023Article
- Nanoscale Bilirubin Analysis in Translational Research and Precision Medicine by the Recombinant Protein HUG.International journal of molecular sciences · 2023Article
- Targeting endothelial vascular cell adhesion molecule-1 in atherosclerosis: drug discovery and development of vascular cell adhesion molecule-1-directed novel therapeutics.Cardiovascular research · 2023Review
- Exploring the link between Gilbert's syndrome and atherosclerotic cardiovascular disease: insights from a subpopulation-based analysis of over one million individuals.European heart journal open · 2023Article
- Association between bilirubin levels with incidence and prognosis of stroke: A meta-analysis.Frontiers in neuroscience · 2023Article
- Endothelial senescence in vascular diseases: current understanding and future opportunities in senotherapeutics.Experimental & molecular medicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundBilirubin may protect against cardiovascular disease (CVD) by reducing oxidative stress. Whether elevated bilirubin reduces the risk of CVD events among HIV METHODS AND
resultsWe conducted a prospective cohort study using VACS participants free of baseline CVD. Total bilirubin was categorized by quartiles. CVD as well as acute myocardial infarction, heart failure, and ischemic stroke events were assessed. Cox regression was used to evaluate hazard ratios of outcomes associated with quartiles of total bilirubin in HIV
conclusionsVACS participants (regardless of HIV status) with elevated bilirubin levels had a lower risk of incident total CVD, acute myocardial infarction, heart failure, and ischemic stroke events after adjusting for known risk factors. Future studies should investigate how this apparently protective effect of elevated bilirubin could be harnessed to reduce CVD risk or improve risk estimation among HIV
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.