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Nonlinear relationship between serum total bilirubin levels and initial ischemic stroke in patients with non-valvular

Ying Liu1, Jie Wang2,3, Wen-Zhen Zeng2

  • 1Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China.

The Journal of International Medical Research
|October 26, 2020
PubMed

Insights

Total bilirubin levels are linked to ischemic stroke risk in patients with non-valvular atrial fibrillation. Higher bilirubin may increase stroke risk, with an optimal level identified for the lowest risk.

Area of Science:

  • Cardiology
  • Neurology
  • Biochemistry

Background:

  • Non-valvular atrial fibrillation (NVAF) is a major risk factor for ischemic stroke.
  • Understanding biomarkers that predict stroke risk in NVAF patients is crucial for prevention.

Purpose of the Study:

  • To investigate the association between serum total bilirubin levels and the incidence of initial ischemic stroke in patients diagnosed with NVAF.

Main Methods:

  • Retrospective study design involving 316 NVAF patients.
  • Diagnosis of atrial fibrillation via 24-hour Holter ECG; ischemic stroke confirmed by clinical presentation and imaging.
  • Multivariate Cox proportional hazards and survival analyses were employed to assess the relationship between total bilirubin quintiles and stroke risk.

Main Results:

  • A total of 42 (13.29%) first ischemic strokes occurred during follow-up.
  • Each 1 µmol/L increase in total bilirubin was associated with a 4% rise in ischemic stroke risk (95% CI: 1.01, 1.07) after adjustment.
  • The lowest risk of ischemic stroke was observed at a total bilirubin level of 17.0 µmol/L.

Conclusions:

  • Serum total bilirubin levels exhibit a nonlinear association with the risk of initial ischemic stroke in patients with non-valvular atrial fibrillation.
  • These findings suggest total bilirubin may serve as a potential predictive biomarker for ischemic stroke in this patient population.
Abstract

Keywords:
Holter electrocardiogramTotal bilirubinantiplatelet drugischemic strokelipoproteinnon-valvular atrial fibrillation

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