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The Association between Serum Total Bile Acid Level and Long-Term Prognosis in Patients with Coronary Chronic Total
Xinchun Zeng1, Zhijie Jian2, Shanshan Li1,3,4
1Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Insights
Serum total bile acids (TBA) can predict major adverse cardiovascular events (MACE) in patients with coronary chronic artery occlusion (CTO) undergoing percutaneous coronary intervention (PCI). Moderate TBA levels are associated with a reduced risk of MACE.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Bile acids are crucial for cholesterol elimination and play a role in coronary artery disease (CAD).
- Limited research exists on the predictive value of serum total bile acids (TBA) for adverse cardiovascular events in coronary chronic artery occlusion (CTO).
Purpose of the Study:
- To investigate the relationship between serum TBA levels and long-term prognosis in patients with CTO undergoing percutaneous coronary intervention (PCI).
Main Methods:
- Serum TBA levels were measured in 613 CTO patients post-PCI.
- Patients were grouped based on TBA levels (median 3.5 µmol/l and upper normal limit 10 µmol/l).
- Primary endpoint was all-cause mortality; secondary endpoint was major adverse cardiovascular events (MACE).
Main Results:
- A moderate TBA level (3.5–10 µmol/l) was associated with a significantly reduced risk of MACE (HR: 0.59, 95% CI: 0.40–0.88) compared to lower levels.
- TBA levels did not predict all-cause mortality or cardiovascular death.
- Spline analysis revealed an L-shaped relationship between serum TBA and MACE incidence.
Conclusions:
- Moderate fasting serum TBA levels possess predictive value for MACE in CTO patients undergoing PCI.
- This predictive value remains significant after adjusting for clinical and lifestyle risk factors.
Background And Aims:
Bile acids, the key products for elimination of cholesterol, play an important role in coronary artery disease (CAD). However, few studies focused on the roles of more accessible serum total bile acids (TBA) in the prediction of adverse cardiovascular events for coronary chronic artery occlusion (CTO). The aim of this study was to explore the potential relationship between serum TBA and long-term prognosis in patients with CTO undergoing percutaneous coronary intervention (PCI).
Methods:
Baseline TBA was determined in 613 patients with CTO after PCI in the present study. All patients were divided into 3 groups according to the median (3.5 μmol/l) and the normal upper limit of the TBA (10 μmol/l). The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events (MACE).
Results:
Average age in this study was 65.44 ± 9.94 years old. The median of TBA was 3.5 (2.1-6.1) μmol/l. Over a median follow-up of 33.5 months, compared to those with below 3.5 μmol/l TBA, 3.5 ~ 10 μmol/l TBA was associated with significantly reduced risk for the MACE (hazard ratio (HR): 0.59, 95% confidence interval (CI): 0.40 to 0.88; p = 0.009) even after adjustment for baseline variables. However, TBA did not predict all-cause mortality and cardiovascular death. Spline analyses showed an L-shaped relationship of the serum TBA with the incidence of MACE.
Conclusions:
Moderate fasting serum TBA level has a predictive value for MACE even after adjusting for lifestyle and clinical risk factors in CTO patients undergoing PCI.
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