SynthesisFrontiers in cardiovascular medicine2026
Prognostic value of total bilirubin level for patients suffering from coronary heart disease undergoing percutaneous coronary intervention: a meta-analysis.
Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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3 authors.
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Abstract
Objective: The objective of this study is to explore the prognostic value of serum total bilirubin for major adverse cardiovascular events (MACE), cardiovascular death (CV death), and all-cause mortality in coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Methods: Databases (PubMed, Cochrane Library, Embase, Web of Science) were searched up to May 2026). Studies were screened via PICOS. Two researchers independently extracted data and assessed study quality using Newcastle-Ottawa Scale. Meta-analysis was performed using STATA 16.0. Subgroup analysis was performed to explore the source of heterogeneity, and Egger's test was conducted to examine publication bias. Results: In total, 17 observational studies involving 27,580 patients with CHD undergoing PCI were included. Methodological quality was generally high (NOS score ≥7). The primary analyses were performed with Conclusion: Serum total bilirubin shows a context-dependent bidirectional association with adverse outcomes in patients with CHD after PCI, but does not demonstrate a consistent independent prognostic value. The apparent protective effect observed in long-term follow-up, older, or stable CHD populations and the risk-elevating effect in the in-hospital acute phase are exploratory findings that require further validation. Given the extremely high heterogeneity (mainly due to inconsistencies in MACE endpoint definitions, liver disease exclusion criteria, and CHD subtype classifications) and the negative dose-response analysis (likely underpowered), current evidence does not support total bilirubin as a robust or generalizable prognostic biomarker. Future prospective studies with standardized designs are needed to elucidate its potential clinical utility. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1067176, identifier CRD420251067176.
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