الفهرس 
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Abstract
This study was aimed to show the relation between serum total bilirubin and different types of acute coronary syndrome (STEMI, NonSTEMI,unstable angina) in patients admitted at Coronary Care Unite of Sohag University Hospital.
This study conducted on 100 patients with ACS at Sohag University CCU from January 2020 to June 2020.
We exclude any patient with non cardiac chest pain, liver cirrhosis, hepatitis of any cause, hemolytic jaundice, obstruction of bile duct, hepatotoxic drugs, recent surgery or recent major trauma.
All patients were subjected to: full history taking, general examination and Laboratory investigations (CBC, Troponin I and CK-MB, creatine, liver enzymes, liver function (total bilirubin, direct bilirubin and indirect bilirubin ), resting 12 lead ECG &US.
The mean age was 55.4 years; 64 (64%) were males, 44 (44%) were current smokers, 37 (37%) were HTN, 39 (39%) were DM, 71 (71%) had family history of IHD, 17 (17%) were obese.
When the patients were divided into 3 groups (group A, n = 28 ”28%”, group B, n = 13 ”13%”, group C, n = 59”59%”), the serum total bilirubin was significantly diffrtent (group A; Mean ± SD = 0.627 ± 0.241), (group B; Mean ± SD = 0.527 ± 0.173), (group C; Mean ± SD = 0.795 ± 0.367). ”P-value = 0.007; highly significant”.
After comparing the three groups, we found that serum total bilirubin is highest in group (C), followed by group (A, B) respectively.
According to this analysis there is an inverse correlation of bilirubin with ACS. This strength the fact that bilirubin acts as an antioxidant and has cardioprotective action and patients with ACS have lower levels of bilirubin. This can use as a factor for screening individuals who have high risk for ACS and preventive strategies applied in them before the onset of overt ACS.
Our study found that hypertension, smoking and family history of IHD were significantly correlated with ACS and there is statistically significance less total bilirubin of ACS than normal standard mean value.
CONCLUSIONS
This study revealed that there is an inverse relation of bilirubin with ACS. This strengths the fact that bilirubin acts as an antioxidant and has cardioprotective action and patients with ACS have lower levels of bilirubin. This could suggest bilirubin as a factor for screening individuals who have high risk for ACS and preventive strategies applied in them before the onset of overt ACS.