Evidence map›Paper›PMID 36324069›Full record

SynthesisBMC cardiovascular disorders2022

Role of bilirubin in the prognosis of coronary artery disease and its relationship with cardiovascular risk factors: a meta-analysis.

Xiao-Ling Li, Cun-Rui Zhao, Chen-Liang Pan, Gaxue Jiang, Bo Zhang

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in BMC cardiovascular disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Xiao-Ling Li *Department of Neurology, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China.
Cun-Rui Zhao *Department of Cardiology, The First Hospital of Lanzhou University, No.1, Donggang West Road, Lanzhou, 730013, Gansu, China.
Chen-Liang PanDepartment of Cardiology, The First Hospital of Lanzhou University, No.1, Donggang West Road, Lanzhou, 730013, Gansu, China.
Gaxue JiangDepartment of Cardiology, The First Hospital of Lanzhou University, No.1, Donggang West Road, Lanzhou, 730013, Gansu, China.
Bo ZhangDepartment of Cardiology, The First Hospital of Lanzhou University, No.1, Donggang West Road, Lanzhou, 730013, Gansu, China. ery_lixlery@lzu.edu.cn.
Lanzhou University · CNFirst Hospital of Lanzhou University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBilirubin is a heme catabolism product with antioxidant, anti-inflammatory, and anti-apoptotic properties and is implicated in the prognosis of several diseases. This study evaluates the prognostic role of bilirubin in coronary artery disease (CAD) patients.

methodsAfter identifying studies from the literature, meta-analyses were performed to achieve a) overall estimates of serum total bilirubin levels in patients with myocardial infarction (MI), non-MI CAD and healthy individuals; b) odds ratios (OR) of adverse outcomes between higher and lower total bilirubin levels; c) standardized mean difference (SMD) in total bilirubin levels in patients with high vs low CAD severity; and d) correlation between disease severity and total bilirubin. Metaregression analyses were performed to examine the relationship between cardiovascular risk factors and increasing quantiles of total bilirubin levels.

resultsForty-three studies were identified. Pooled serum total bilirubin levels were 0.72 mg/dl [95% confidence interval (CI): 0.60, 0.83] in MI patients; 0.65 mg/dl [95% CI: 0.60, 0.69] in non-MI CAD patients; and 0.66 mg/dl [95% CI: 0.56, 0.75] in healthy individuals. Higher total bilirubin levels were associated with greater odds of adverse outcomes in MI patients (OR: 1.08 [95% CI: 0.99, 1.18]) but lower odds in non-MI CAD patients (OR: 0.80 [95%CI: 0.73, 0.88]). Compared to non-severe cases, total bilirubin levels were higher in patients with severe MI (SMD 0.96 [95% CI: - 0.10, 2.01]; p = 0.074) but were lower in severe non-MI CAD patients (SMD - 0.30 [95%CI: - 0.56, - 0.03]; p = 0.02). Total bilirubin levels correlated positively with MI severity (r = 0.41 [95% CI: 0.24, 0.59]; p < 0.01) but correlated negatively with non-MI CAD severity (r =  - 0.17 [95% CI: - 0.48, 0.14]; p = 0.28). Female sex was inversely associated with increasing quantiles of bilirubin (meta-regression coefficient: - 8.164 [- 14.531, - 1.769]; p = 0.016) in MI patients.

conclusionPrognostic role of bilirubin for CAD appears complicated, as different odds are observed for MI and non-MI CAD patients which weakens the case of causal involvement of bilirubin in CAD etiology or prognosis.

Indexed as

Coronary Artery DiseaseMyocardial InfarctionBilirubinFemaleHumansOdds RatioPrognosisRisk FactorsBilirubinBilirubinCoronary heart diseasePrognosis

Identifiers

PMID36324069
PMCPMC9632050
OpenAlexW4308432208

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.