Association of bilirubin with cardiovascular outcomes: more hype than substance?

The field of epidemiology has seen many parameters enter the arena as risk factors. Many of them left the scene without leaving a mark, which was often caused by chance findings caused by small sample sizes or spurious associations resulting from confounding by other risk factors. Others became firmly established as risk factors, and therefore drug targets, but finally were dethroned by exclusion of causality, as it was recently reported for C-reactive protein.1 Such parameters are then no longer handled as risk factors but as markers of the diseases, which might still be quite helpful for diagnostic purposes.