纤维蛋白原/白蛋白比值与充血性心力衰竭患者造影剂诱导的急性肾损伤的发生相关。
Fibrinogen/Albumin Ratio is Associated with the Occurrence of Contrast-Induced Acute Kidney Injury in Patients with Congestive Heart Failure.
作者信息
Zhang GuangHui, Huang Dehua, Chen Jieyi, Yang Xi, Ruan Huangtao, Huang Xiaoyu
机构信息
First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China.
Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, People's Republic of China.
出版信息
J Inflamm Res. 2025 Apr 17;18:5149-5159. doi: 10.2147/JIR.S507160. eCollection 2025.
PURPOSE
Patients with congestive heart failure (CHF) are associated with an elevated risk of mortality and poor prognosis. Contrast-induced acute kidney injury (CI-AKI), a common complication in CHF patients undergoing contrast-enhanced procedures, exacerbates renal dysfunction and contributes to adverse outcomes. However, the relationship between the preoperative fibrinogen/albumin ratio (FAR) and the risk of CI-AKI or all-cause mortality in CHF remains unclear. This study analyzed the correlation of FAR with the risk of CI-AKI and all-cause mortality in patients with CHF.
PATIENTS AND METHODS
In this retrospective observational study, CHF patients undergoing coronary angiography (CAG) were enrolled and grouped according to their FAR quartiles. The association between FAR and clinical outcomes was assessed using the multivariate logistic regression and restricted cubic spline (RCS) analyses.
RESULTS
This study included 7,235 CHF patients with a mean age of 65.8 ± 11.7 years. Among these, 2,100 were female (29.0%), and 1,094 (15.1%) experienced CI-AKI. FAR showed a non-linear relationship with CI-AKI (p < 0.001). The risk of CI-AKI was significantly higher with increasing FAR. After adjusting for all the potential confounding variables, the risk of CI-AKI was highest in patients with FAR >0.150 (OR = 1.572, 95% CI 1.237-2.004, p < 0.001). Multivariate COX proportional risk model showed that the risk of all-cause mortality was highest in CHF patients with FAR > 0.150 (HR = 1.20, 95% CI 1.04-1.38, p = 0.014).
CONCLUSION
FAR is an independent risk factor for the occurrence of CI-AKI in patients with CHF.
目的
充血性心力衰竭（CHF）患者的死亡风险升高且预后较差。造影剂诱导的急性肾损伤（CI-AKI）是接受造影增强检查的CHF患者常见的并发症，会加重肾功能不全并导致不良后果。然而，术前纤维蛋白原/白蛋白比值（FAR）与CHF患者发生CI-AKI或全因死亡风险之间的关系仍不清楚。本研究分析了FAR与CHF患者发生CI-AKI及全因死亡风险的相关性。
患者与方法
在这项回顾性观察研究中，纳入接受冠状动脉造影（CAG）的CHF患者，并根据其FAR四分位数进行分组。使用多因素逻辑回归和限制性立方样条（RCS）分析评估FAR与临床结局之间的关联。
结果
本研究纳入了7235例CHF患者，平均年龄为65.8±11.7岁。其中，女性2100例（29.0%），1094例（15.1%）发生CI-AKI。FAR与CI-AKI呈非线性关系（p<0.001）。随着FAR升高，CI-AKI风险显著增加。在调整所有潜在混杂变量后，FAR>0.150的患者发生CI-AKI的风险最高（OR=1.572，95%CI 1.237-2.004，p<0.001）。多因素COX比例风险模型显示，FAR>0.150的CHF患者全因死亡风险最高（HR=1.20，95%CI 1.04-1.38，p=0.014）。
结论
FAR是CHF患者发生CI-AKI的独立危险因素。
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