ArticleAnnals of translational medicine2019
Association of circulating total bilirubin level with ischemic stroke: a systemic review and meta-analysis of observational evidence.
Article in Annals of translational medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
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The trial behind it
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Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Bilirubin as a predictor of severity and adverse clinical outcomes of acute ischemic stroke: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Association of Blood Amyloid Beta-Protein 1-42 with Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis.BioMed research international · 2022Pooled it
- The Nonlinear Relationship Between Total Bilirubin and Coronary Heart Disease: A Dose-Response Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- Association between ALBI score and stroke risk and all-cause mortality: 2011 to 2018 NHANES.Medicine · 2025Article
- Association between serum total bilirubin levels and 28-day all-cause mortality after intracerebral hemorrhage.Frontiers in neurology · 2025Article
- Predictors of early neurological deterioration in patients with acute ischemic stroke.Frontiers in neurology · 2024Article
- Elevated SIRT2 of serum exosomes is positively correlated with diagnosis of acute ischemic stroke patients.BMC neurology · 2023Article
- The J-shape Association between Total Bilirubin and Stroke in Older Patients with Obstructive Sleep Apnea Syndrome: A Multicenter Study.The journal of nutrition, health & aging · 2023Article
- Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset.Frontiers in neurology · 2023Article
- Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV.Frontiers in neurology · 2023Article
- Effect of bilirubin and Gilbert syndrome on health: cohort analysis of observational, genetic, and Mendelian randomisation associations.BMJ medicine · 2023Article
- Association between bilirubin levels with incidence and prognosis of stroke: A meta-analysis.Frontiers in neuroscience · 2023Article
- Higher serum bilirubin levels are associated with hemorrhagic transformation after intravenous thrombolysis in acute ischemic Stroke.Frontiers in aging neuroscience · 2023Article
- Nomogram for Persistent Post-Stroke Depression and Decision Curve Analysis.Clinical interventions in aging · 2022Article
- Biliverdin/Bilirubin Redox Pair Protects Lens Epithelial Cells against Oxidative Stress in Age-Related Cataract by Regulating NF-Oxidative medicine and cellular longevity · 2022Article
- Serum bilirubin levels are associated with poor functional outcomes in patients with acute ischemic stroke or transient ischemic attack.BMC neurology · 2021Article
- Association of Serum Bilirubin with the Severity and Outcomes of Intracerebral Hemorrhages.Antioxidants (Basel, Switzerland) · 2021Article
- Article
- Nonlinear relationship between serum total bilirubin levels and initial ischemic stroke in patients with non-valvular atrial fibrillation.The Journal of international medical research · 2020Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCirculating total bilirubin is a biomarker of ischemic stroke and may serve as a potential prognostic factor. It is imperative to systemically evaluate the correlation between circulating total bilirubin and risk for stroke. This systematic review and meta-analysis investigated the relationship between total serum bilirubin and risk for stroke.
methodsStudies published before 30 June 2017 were searched in four databases (PubMed, EMBASE, Web of Science and Cochrane Central). Additional studies were searched by reviewing references and contacting authors. Cohort, cross-sectional and case-control studies in adults that examined the association between serum total bilirubin and stroke were included irrespective of language and date of publication. The primary outcome of this study was ischemic stroke, and the secondary outcome was stroke. Abstract and full-text were reviewed by two independent reviewers, and disagreement was resolved by consulting a third reviewer. Data were extracted by two independent reviewers using a pre-designed data collection form.
resultsEleven observational studies (5 prospective and 6 cross-sectional studies) involving 131,450 subjects were included for analysis. In four studies with 83,380 subjects, the relationship between circulating total bilirubin and ischemic stroke was investigated, ischemic stroke was found in 2,496 patients, and the total odds ratio (OR) of the highest bilirubin and the lowest bilirubin for the occurrence of ischemic stroke was 0.66 (95% CI: 0.58-0.74). Eleven studies with 131,450 subjects explored the correlation between bilirubin and stroke, stroke was reported in 5,060 patients, and the total OR of the highest bilirubin and the lowest bilirubin for the occurrence of stroke was 0.73 (95% CI: 0.68-0.79). A stratified analysis based on the gender showed that the total bilirubin level in males correlated with ischemic stroke or stroke, which was not noted in females.
conclusionsThe available studies support an inverse association between circulating total bilirubin and risk for ischemic stroke and stroke in males. Prospective studies with large sample size are needed to establish the role of circulating bilirubin in the prevention of stroke.
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