Serum Bilirubin Level and Aortic Intima–Media Thickness in Patients Without Clinical Manifestation of Atherosclerotic Cardiovascular Disease

We investigated the association between serum bilirubin level and thoracic aortic intima–media thickness (IMT). The study population consisted of 417 patients without coronary artery disease, who underwent transesophageal echocardiography examination for various indications. The highest aortic IMT values were observed in the bilirubinlow group compared with the bilirubinhigh group (P < .001). Serum bilirubin level was associated with high-density lipoprotein cholesterol level (r = .162, P = .001), high-sensitivity C-reactive protein (hsCRP; r = −.265, P < .001), and aortic IMT (r = −.551, P < .001) in bivariate analysis. Multivariate linear regression analysis showed that serum bilirubin level was independently and negatively associated with hsCRP (β = −.095, P = .028) and aortic IMT (β = −.513, P < .001). Serum bilirubin level may be an independent predictor of the extent of subclinical aortic atherosclerosis assessed by thoracic aortic IMT.