Abstract
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.
Highlights
Acute coronary syndrome (ACS) is today one of the leading causes of morbidity and mortality in the world
The aim of the present study is to investigate the relationship between fibrinogen-to-albumin ratio (FAR) and severity of coronary artery disease (CAD) measured by the Gensini Score (GS), and the prognostic value of FAR in predicting long-term prognosis in NSTE-ACS patients firstly implanted with drug-eluting stent (DES)
The results showed that FAR was significantly and positively correlated with the GS, a scoring system used to determine the severity of CAD, and elevated FAR was an independent risk factor for severe CAD
Summary
Acute coronary syndrome (ACS) is today one of the leading causes of morbidity and mortality in the world. Despite of the use of current guideline-recommended therapies, including prompt coronary revascularization, dual antiplatelet therapy, and intensive lipid-lowering therapy, ACS patients still have a poor prognosis [1,2,3]. Early risk stratification is essential for making clinical decision and evaluating prognosis. ACS is a group of clinical syndromes, including non-ST elevation acute coronary syndrome (NSTE-ACS) and ST elevation acute myocardial infarction (STEMI), with the pathogenesis of vulnerable plaque rupture, subsequent red or white thrombosis, thereby resulting in incomplete or complete vascular occlusion [4]. The typical plaque is characterized by a large central lipid core, an abundance of inflammatory cells, a thin fibrous cap, and a paucity of smooth muscle cells [5]. Previous study noted that inflammatory response was a key regulator in the degradation of extracellular collagen, which in turn
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