Association of low serum bilirubin and peripheral arterial
disease in coronary heart disease patients

Janardhanan S¹, Anitha Achuthan²

¹II year Post-graduate,
²Professor & HOD,
Department of Physiology,
Chengalpattu Medical College,
Chengalpatttu, Tamil Nadu, India

Abstract
  • Background: High serum bilirubin is considered to be an unfavourable prognostic factor in hepatobiliary disorders. Evidence that low serum bilirubin is associated with myasthenia gravis, Alzheimer’s disease, ulcerative colitis, Crohn’s disease, diabetic complications, and immunological disorders has suggested the possibility that endogenous bilirubin, presumably owing to its antioxidant properties, may act protectively against conditions that develop or progress due to redox imbalance. A recent study has shown that administration of bilirubin suppresses atherosclerotic formation in an animal model. However, information on the association between serum bilirubin and peripheral arterial disease (PAD) seems to be limited. The study aims to find the association between low serum bilirubin and peripheral arterial disease in coronary artery heart disease patients.
  • Materials and Methods: Cardiac patients with history of Angioplasty and Bypass surgery in Chengalpattu Medical College Cardiology department were taken as subjects after obtaining Institutional Ethics Committee approval. Subjects were divided into two groups with 30 subjects in each. Group I of patients with coronary artery heart disease alone and Group II of patients with coronary artery heart disease and peripheral arterial disease. Both groups include patients of both gender and 30 – 55 yrs of age. Inclusion criteria was patients having coronary artery heart disease. Exclusion criteria were persons with liver pathologies, cardiac failure, filariasis, trauma lower limbs. Study was done in Department of Physiology, Chengalpattu Medical College. The research study was carried after obtaining written and informed consent from the participants.
  • Results: The results show that the mean serum bilirubin of group I was 0.48 ±0.13 and the mean serum bilirubin of Group II was 0.29±0.10. These results show a significant p value of less than 0.05, which confers that low serum bilirubin level, may be associated with peripheral arterial disease in coronary artery disease patients.
  • Conclusion: Our study found a significant association between low serum bilirubin and increased incidence of peripheral arterial disease in coronary artery disease patients. This is suggestive of reduced bilirubin’s antioxidant effect resulting in peripheral arterial disease.

Keywords: antioxidant effect, coronary artery disease, serum bilirubin