Association of serum total bilirubin with recurrent cardiovascular events in patients with in-stent restenosis: a stratified analysis by inflammatory status

作者：Miao Yu, Yu Jiang, Yu Sun, Han Zhang, Tianjie Wang, Tao Tian, Jian-Song Yuan, Haiyan Qian, Wei-Xian Yang · 发表于：BMC Cardiovascular Disorders · 年份：2026 · DOI：10.1186/s12872-026-05680-5 · 被引用次数：1 · 研究领域：Heme Oxygenase-1 and Carbon Monoxide、Cardiac Imaging and Diagnostics、Parathyroid Disorders and Treatments

BACKGROUND: In-stent restenosis (ISR) remains a major clinical challenge despite advances in stent technology and pharmacotherapy. While inflammation plays a pivotal role in ISR progression, the prognostic value of stable biomarkers reflecting chronic inflammation has not been fully explored. This study examined the association of serum total bilirubin (TBIL), alone and in combination with high-sensitivity C-reactive protein (hsCRP), with long-term cardiovascular outcomes in ISR patients undergoing percutaneous coronary intervention (PCI). METHODS: A total of 2055 ISR patients who underwent repeat PCI at Fuwai Hospital from January 2017 to December 2018 were consecutively enrolled. Patients were stratified based on TBIL and hsCRP levels. The primary endpoint was the incidence of major adverse cardiovascular events (MACEs), including all-cause mortality, myocardial infarction, stroke, repeat revascularization and stent thrombosis. Multivariable Cox regression and subgroup analyses were conducted. RESULTS: During a median follow-up of 36 months, 457 patients suffered from MACEs. Lower TBIL levels were independently associated with a higher risk of long-term MACEs, regardless of high hsCRP (hsCRP ≥ 2 mg/L, hazard ratio [HR] = 1.865, 95% confidence interval [CI] 1.423–2.443, P < 0.001) or low hsCRP (hsCRP < 2 mg/L HR = 1.338, 95% CI: 1.039–1.721, P = 0.024). Kaplan-Meier curves showed that patients with both low TBIL and elevated hsCRP had the highest incidence of MACEs (P < 0.00...