Fasting serum total bile acid level is associated with coronary artery disease, myocardial infarction and severity of coronary lesions. (January 2020)

• Record Type: Journal Article
• Authors: Li, Wenyuan; Shu, Shan; Cheng, Lele; Hao, Xiang; Wang, Lijun; Wu, Yue; Yuan, Zuyi; Zhou, Juan
• Is Part Of: Atherosclerosis. Volume 292(2020)
• Page Start: 193
• Page End: 200
• Publication Date: 2020-01
• Subjects: Coronary artery disease -- Myocardial infarction -- Gensini score -- Fasting serum total bile acids; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2019.11.026
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Bile acids play important roles in lipid metabolism. Several studies have found that patients with coronary artery disease (CAD) have lower bile acid fecal excretion compared to individuals without CAD. However, few studies have focused on the roles of more accessible serum total bile acids (TBA) in the progression of CAD. The aim of this study was to explore the potential relationship between fasting serum TBA and the presence of CAD, myocardial infarction (MI) and severity of coronary lesions. Methods: A total of 7438 consecutive patients with suspected CAD, who had undergone coronary angiography, were enrolled. The severity of coronary lesions was evaluated using the Gensini score (GS). The relationships between fasting serum TBA and the presence and severity of CAD were evaluated. Results: CAD patients had lower serum TBA than individuals without CAD, and patients with MI had lower TBA than those without CAD. Spline analyses showed an L-shaped relationship of the fasting serum TBA with the presence and severity of CAD, and the breakpoint approximated the normal upper limit (10 μmol/L). A lower TBA concentration (less than the median 3.6 μmol/L) was independently and significantly associated with the presence and severity of CAD, especially for the presence of MI (odds ratios 2.04, 95% confidence interval (1.71–2.44), C-index 0.9269). Conclusions: Fasting serum TBA level is highly associated with the presence and severity of CAD in patients undergoing coronary angiography for suspected CAD. Graphical abstract: Image 1 Highlights: A total of 7438 patients with suspected coronary artery disease were included. Lower fasting serum total bile acids levels were highly and independently associated with the presence and severity of coronary artery disease (CAD). No additional protective association was found above the normal upper limit of serum total bile acids. Fasting serum total bile acids might be a useful biomarker to predict the presence and severity of CAD.