Observational studyBMC cardiovascular disorders2026
Association of serum total bilirubin with recurrent cardiovascular events in patients with in-stent restenosis: a stratified analysis by inflammatory status.
Observational study in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of total bilirubin level for patients suffering from coronary heart disease undergoing percutaneous coronary intervention: a meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
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Authors and funding
9 authors.
Funding
Abstract
backgroundIn-stent restenosis (ISR) remains a major clinical challenge despite advances in stent technology and pharmacotherapy. While inflammation plays a pivotal role in ISR progression, the prognostic value of stable biomarkers reflecting chronic inflammation has not been fully explored. This study examined the association of serum total bilirubin (TBIL), alone and in combination with high-sensitivity C-reactive protein (hsCRP), with long-term cardiovascular outcomes in ISR patients undergoing percutaneous coronary intervention (PCI).
methodsA total of 2055 ISR patients who underwent repeat PCI at Fuwai Hospital from January 2017 to December 2018 were consecutively enrolled. Patients were stratified based on TBIL and hsCRP levels. The primary endpoint was the incidence of major adverse cardiovascular events (MACEs), including all-cause mortality, myocardial infarction, stroke, repeat revascularization and stent thrombosis. Multivariable Cox regression and subgroup analyses were conducted.
resultsDuring a median follow-up of 36 months, 457 patients suffered from MACEs. Lower TBIL levels were independently associated with a higher risk of long-term MACEs, regardless of high hsCRP (hsCRP ≥ 2 mg/L, hazard ratio [HR] = 1.865, 95% confidence interval [CI] 1.423–2.443, P < 0.001) or low hsCRP (hsCRP < 2 mg/L HR = 1.338, 95% CI: 1.039–1.721, P = 0.024). Kaplan-Meier curves showed that patients with both low TBIL and elevated hsCRP had the highest incidence of MACEs (P < 0.001). The combination of TBIL and hsCRP provided additional risk stratification information, especially in patients with diabetes mellitus (P for interaction = 0.001).
conclusionSerum TBIL is a novel, independent predictor of adverse outcomes in ISR patients and provides complementary value to hsCRP for risk stratification. Its clinical utility may be particularly valuable in diabetic populations, suggesting that TBIL may help identify higher-risk subgroups within ISR populations. CLINICAL
trial registrationThis study is not a registered clinical trial. Clinical trial registration: not applicable.
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