Bilirubin and coronary heart disease risk in the Prospective Epidemiological Study of Myocardial Infarction (PRIME)
- 1 February 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in European Journal of Preventive Cardiology
- Vol. 14 (1), 79-84
- https://doi.org/10.1097/01.hjr.0000230097.81202.9f
Abstract
Classic coronary heart disease risk factors fail to explain the large coronary heart disease incidence gradient between Northern Ireland and France. The Prospective Epidemiological Study of Myocardial Infarction (PRIME), a multicentre prospective study of 10 593 men, aims to investigate novel risk factors in these populations. We tested the hypothesis that higher bilirubin, a bile pigment possessing antioxidant properties, is associated with decreased coronary heart disease risk. Bilirubin was measured in 216 participants who had developed coronary heart disease at 5-year follow-up and in 434 matched controls. Bilirubin was significantly lower in cases (geometric mean 7.95 μmol/l; interquartile range 5.32–12.33 μmol/l) compared with controls (9.07; 6.16–12.76; P = 0.005). Conditional logistic regression, adjusted for classical and putative risk factors, showed a U-shaped pattern, with coronary heart disease risk significantly lower for bilirubin in the third and fourth fifths, compared with the first. Additionally, there was a significant quadratic relationship between coronary heart disease risk and fifths of bilirubin concentration (χ2 = 6.80, df = 2; P = 0.035). These findings suggest that bilirubin is a novel coronary heart disease risk marker in middle-aged men, with a U-shaped relationship observed between bilirubin concentration and coronary heart disease risk. Eur J Cardiovasc Prev Rehabil 14: 79-84 © 2007 The European Society of CardiologyKeywords
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