Bilirubin and cardiovascular risk

Abstract

This literature review demonstrates the results of experimental and clinical studies, as well as data from meta-analyzes on the effect of bilirubin levels on cardiovascular system. Recent studies provided a new look at the role of bilirubin in cardiovascular disease. Modern concepts consider bilirubin as a powerful endogenous antioxidant with anti-inflammatory effects, capable of influencing the course of atherosclerotic cardiovascular diseases and reducing ischemic damage. The change in bilirubin levels affects the coronary blood flow, the development of collateral circulation and the morphology of coronary plaques. A low bilirubin level is associated with an increase in left ventricular mass and a decrease in its contractility, which, in turn, leads to heart failure and increases the risk of rehospitalizations. Taking into account the above effects of bilirubin, there was interest in assessing the effect of its blood level on the risk of atherosclerotic cardiovascular diseases. Recent studies have attempted to create risk stratification models for adverse cardiovascular events based on bilirubin levels.