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Coronary Artery Disease in Patients With Disorders of Bilirubin Excretion

Nancy Gupta1, Rahul Chaudhary, Parasuram Krishnamoorthy

  • 11Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY; 2Department of Medicine, Sinai Hospital of Baltimore, Johns Hopkins University, Baltimore, MD; 3Department of Medicine, Englewood Hospital and Medical Center, Mount Sinai School of Medicine, Englewood, NJ; 4Government Medical College, Amritsar, India; and 5Department of Medicine, Division of Gastroenterology and Hepatobiliary Disease, New York Medical College, Westchester Medical Center, Valhalla, NY.

American Journal of Therapeutics
|October 9, 2015
PubMed

Insights

Coronary artery disease (CAD) is prevalent in patients with bilirubin excretion disorders. Hypertension, hyperlipidemia, diabetes, and age are key predictors of CAD in this population.

Area of Science:

  • Cardiology
  • Hepatology
  • Medical Informatics

Background:

  • Disorders of bilirubin excretion, including Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome, are relatively uncommon genetic conditions.
  • The association between these disorders and the prevalence of coronary artery disease (CAD) has not been extensively studied.
  • Understanding cardiovascular risk factors in patients with bilirubin excretion disorders is crucial for comprehensive patient management.

Purpose of the Study:

  • To identify predictors of coronary artery disease (CAD) in adult patients diagnosed with disorders of bilirubin excretion.
  • To analyze the prevalence of CAD within a large cohort of patients with abnormal bilirubin metabolism.
  • To investigate the influence of traditional cardiovascular risk factors on CAD development in this specific patient group.

Main Methods:

  • Utilized data from the Healthcare Cost and Utilization Project (HCUP) for the years 2009-2010.
  • Included adult patients (≥18 years) with a primary diagnosis of "disorders of bilirubin excretion" (ICD-9CM code 277.4).
  • Employed multivariate logistic regression analysis, adjusting for demographic and traditional cardiovascular risk factors, to determine independent predictors of CAD.

Main Results:

  • A total of 12,423 adult patients with bilirubin excretion disorders were identified, representing 0.03% of all inpatient admissions.
  • Coronary artery disease (CAD) was present in 18% of these patients, with a higher prevalence in men (21%) compared to women (13%).
  • Independent predictors of CAD included hypertension (OR: 1.74), hyperlipidemia (OR: 2.49), diabetes (OR: 1.46), and increasing age (OR: 1.05). Female sex showed an inverse association (OR: 0.49).

Conclusions:

  • Patients with disorders of bilirubin excretion exhibit a notable prevalence of coronary artery disease (CAD).
  • Traditional cardiovascular risk factors such as hypertension, hyperlipidemia, and diabetes mellitus, along with advanced age, are significant independent predictors of CAD in this population.
  • The findings underscore the importance of screening for and managing cardiovascular risk factors in individuals with abnormal bilirubin excretion.

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