Serum bilirubin improves the risk predictions of cardiovascular and total death in diabetic patients.

•Bilirubin is a potential endogenous inhibitor of atherosclerosis.•Total bilirubin may have a role of protection from cardiovascular death and all-cause death among diabetic patients.•The addition of bilirubin to clinical risk factors in reclassification analysis showed improved risk stratification of cardiovascular death in diabetic patients.