Liu Gao, Fan Chuan-Min, Guo Hao, Fan Wei-Na, Li Ming-Liang, Cui Guo-Xiong
Department of Cardiology, Xianyang Central Hospital, Xianyang, Shaanxi 712000, P.R. China.
Department of Cardiology, Affiliated Hospital of Yan'an University, Yan'an, Shaanxi 716000, P.R. China.
Exp Ther Med. 2021 May;21(5):465. doi: 10.3892/etm.2021.9896. Epub 2021 Mar 8.
The fibrinogen-to-albumin ratio index (FAR) is a valuable tool reflecting the systemic inflammation level and associated with the severity of coronary artery disease. However, the utility of the FAR in predicting the long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) and multivessel disease has remained to be determined. A total of 424 patients diagnosed with STEMI and multivessel disease were recruited for the present study. They were given emergent percutaneous coronary intervention treatment and then completed a follow-up for primary (all-cause mortality) and secondary endpoints (major adverse cardiac events, including MI, stroke, emergent revascularization and rehospitalization due to heart failure). The association between FAR and the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was investigated, while receiver operating characteristic curve analysis was adopted to assess the ability of the FAR to predict long-term outcomes. The long-term survival of high and low FAR groups was compared by drawing Kaplan-Meier survival curves. Multivariate Cox regression analysis was adopted to evaluate the risk factors of primary and secondary endpoints. The FAR was revealed to have a linear correlation with the SYNTAX score (y=0.022x+17.737; P=0.015). Furthermore, the FAR was a significant predictor of all-cause death with a cut-off value of 128.4 (area under the curve, 0.832; P<0.001). A significant difference was determined between the high FAR group and the low FAR group in terms of the proportion of patients with the primary endpoint (P<0.001) and secondary endpoint (P=0.001). It was demonstrated that the FAR was an independent risk factor for all-cause death of patients with STEMI and multivessel disease (hazard ratio, 1.029; 95% CI: 1.020-1.037; P<0.001). In summary, the FAR is a valuable biomarker associated with STEMI and may be useful in the prediction of the long-term prognosis of patients with STEMI and multivessel disease.
纤维蛋白原与白蛋白比值指数（FAR）是反映全身炎症水平的一项重要指标，且与冠状动脉疾病的严重程度相关。然而，FAR在预测ST段抬高型心肌梗死（STEMI）合并多支血管病变患者长期预后方面的效用仍有待确定。本研究共纳入424例诊断为STEMI合并多支血管病变的患者。他们接受了急诊经皮冠状动脉介入治疗，随后完成了对主要终点（全因死亡率）和次要终点（主要不良心脏事件，包括心肌梗死、中风、急诊血运重建以及因心力衰竭再次住院）的随访。研究了FAR与紫杉醇药物洗脱支架与心脏外科手术协同作用（SYNTAX）评分之间的关联，同时采用受试者工作特征曲线分析来评估FAR预测长期预后的能力。通过绘制Kaplan-Meier生存曲线比较高FAR组和低FAR组的长期生存率。采用多变量Cox回归分析评估主要终点和次要终点的危险因素。结果显示，FAR与SYNTAX评分呈线性相关（y = 0.022x + 17.737；P = 0.015）。此外，FAR是全因死亡的显著预测指标，截断值为128.4（曲线下面积为0.832；P < 0.001）。高FAR组和低FAR组在主要终点患者比例（P < 0.001）和次要终点患者比例（P = 0.001）方面存在显著差异。结果表明，FAR是STEMI合并多支血管病变患者全因死亡的独立危险因素（风险比为1.029；95%置信区间：1.020 - 1.037；P < 0.001）。总之,FAR是与STEMI相关的一项重要生物标志物，可能有助于预测STEMI合并多支血管病变患者的长期预后。
