Karahan Oğuz, Acet Halit, Ertaş Faruk, Tezcan Orhan, Çalişkan Ahmet, Demir Muhammed, Kaya Ahmet Ferhat, Demirtaş Sinan, Çevik Mehmet Uğur, Yavuz Celal
Medical School of Dicle University, Department of Cardiovascular Surgery, Diyarbakır, Turkey.
Medical School of Dicle University, Department of Cardiology, Diyarbakır, Turkey.
Am J Emerg Med. 2016 Jun;34(6):1037-42. doi: 10.1016/j.ajem.2016.03.003. Epub 2016 Mar 3.
Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin levels are of a higher specificity and sensitivity in ST-elevation myocardial infarction (STEMI). In this study, we sought to evaluate the association between fibrinogen to albumin ratio (FAR) and the extent and severity of CAD evaluated by TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries (SYNTAX) Score (SS) in patients with STEMI.
A total of 278 patients with STEMI were included in the study. FAR was calculated using specified variables. The extent and severity of CAD were evaluated using the SS. The patients were divided into low- (SS <22) and high- (SS ≥22) risk groups. A Spearman rank correlation coefficient analysis was used for the relationship between FAR and SS. The cutoff points for sensitivity and specificity of FAR in predicting SS were estimated by performing a receiver operator characteristic curve analysis.
There were significant differences in the mean age (P=.016), admission serum albumin (P=.041), serum fibrinogen (P<.001), FAR (P<.001), and SS risk groups. Positive correlation was detected between FAR and SS (r=0.458, P<.001). A cutoff level of >87 FAR predicted SS (sensitivity, 70%; specificity, 70%), and an area under the curve of 0.758 serum fibrinogen and albumin level was an independent predictor for SS in patients with STEMI (b=0.039; 95% confidence interval, 0.016-0.062; P=.001 and b=-6.906; 95% confidence interval, -12.284 to -1.527; P=.013, respectively).
In the present study, we showed that FAR is significantly related to SS in predicting the severity of CAD in patients with STEMI.
既往研究表明，血清纤维蛋白原水平是冠状动脉疾病（CAD）的确立危险因素，且血清白蛋白水平在ST段抬高型心肌梗死（STEMI）中具有更高的特异性和敏感性。在本研究中，我们试图评估纤维蛋白原与白蛋白比值（FAR）与通过TAXUS药物洗脱支架与冠状动脉搭桥手术治疗狭窄动脉（SYNTAX）评分（SS）评估的CAD患者中CAD的范围和严重程度之间的关联。
本研究共纳入278例STEMI患者。使用特定变量计算FAR。使用SS评估CAD的范围和严重程度。将患者分为低风险（SS<22）和高风险（SS≥22）组。采用Spearman等级相关系数分析FAR与SS之间的关系。通过进行受试者工作特征曲线分析来估计FAR预测SS的敏感性和特异性的截断点。
平均年龄（P = 0.016）、入院时血清白蛋白（P = 0.041）、血清纤维蛋白原（P<0.001）、FAR（P<0.001）和SS风险组之间存在显著差异。FAR与SS之间存在正相关（r = 0.458，P<0.001）。FAR>87预测SS（敏感性70%；特异性70%），血清纤维蛋白原和白蛋白水平曲线下面积为0.758是STEMI患者SS的独立预测因子（b = 0.039；95%置信区间，0.016 - 0.062；P = 0.001和b = -6.906；95%置信区间，-12.284至-1.527；P = 0.013）。
在本研究中，我们表明FAR在预测STEMI患者CAD严重程度方面与SS显著相关。
