Relation of Fibrinogen-to-Albumin Ratio to Severity of Coronary Artery Disease and Long-Term Prognosis in Patients with Non-ST Elevation Acute Coronary Syndrome

Abstract EN

Previous studies showed that fibrinogen-to-albumin ratio (FAR) regarded as a novel inflammatory and thrombotic biomarker was the risk factor for coronary artery disease (CAD).

In this study, we sought to evaluate the relationship between FAR and severity of CAD, long-term prognosis in non-ST elevation acute coronary syndrome (NSTE-ACS) patients firstly implanted with drug-eluting stent (DES).

A total of 1138 consecutive NSTE-ACS patients firstly implanted with DES from January 2017 to December 2018 were recruited in this study.

Patients were divided into tertiles according to FAR levels (Group 1: ≤8.715%; Group 2: 8.715%~10.481%; and Group 3: >10.481%).

The severity of CAD was evaluated using the Gensini Score (GS).

The endpoints were major adverse cardiovascular events (MACE), including all-cause mortality, myocardial reinfarction, and target vessel revascularization (TVR).

Positive correlation was detected by Spearman’s rank correlation coefficient analysis between FAR and GS (r=0.170, P<0.001).

On multivariate logistic analysis, FAR was an independent predictor of severe CAD (OR: 1.060; 95% CI: 1.005~1.118; P<0.05).

Multivariate Cox regression analysis indicated that FAR was an independent prognostic factor for MACE at 30 days, 6 months, and 1 year after DES implantation (HR: 1.095; 95% CI: 1.011~1.186; P=0.025.

HR: 1.076; 95% CI: 1.009~1.147; P=0.026.

HR: 1.080; 95% CI: 1.022~1.141; P=0.006).

Furthermore, adding FAR to the model of established risk factors, the C-statistic increased from 0.706 to 0.720, 0.650 to 0.668, and 0.611 to 0.632, respectively.

And the models had incremental prognostic value for MACE, especially for 1-year MACE (NRI: 13.6% improvement, P=0.044; IDI: 0.6% improvement, P=0.042).

In conclusion, FAR was associated independently with the severity of CAD and prognosis, helping to improve risk stratification in NSTE-ACS patients firstly implanted with DES.