Abstract
Background: Increased serum total bilirubin (TB) is associated with increased mortality in patients with symptomatic heart failure (HF), perhaps reflecting greater hepatic congestion. Conversely, increased TB is associated with decreased risk of myocardial infarction (MI) among the general population, perhaps through anti-oxidant effects. It is unknown how TB levels relate to MI in patients with HF nor the mechanism by which beta-blockers reduce MI in HF patients. Methods: Within the clinical trial BEST (comparison of the b-blocker bucindolol to placebo, n = 2708, excluded if TB >3 mg/dL) we determined Cox hazard ratios (HR) for primary and secondary endpoints by tertiles of baseline TB within the placebo and bucindolol groups, and in the entire patient population.
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