The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI

• Published in: The American journal of emergency medicine 2016-06, Vol.34 (6), p.1037-1042
• Main Authors: Karahan, Oğuz, MD, Acet, Halit, MD, Ertaş, Faruk, MD, Tezcan, Orhan, MD, Çalişkan, Ahmet, MD, Demir, Muhammed, MD, Kaya, Ahmet Ferhat, MD, Demirtaş, Sinan, MD, Çevik, Mehmet Uğur, MD, Yavuz, Celal, MD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Age; Age Factors; Aged; Atherosclerosis; Blood; Blood platelets; Cardiology; Cardiovascular disease; Coronary Artery Disease - blood; Coronary Artery Disease - complications; Coronary vessels; Correlation coefficient; Drug-Eluting Stents; Emergency; Emergency medical care; Female; Fibrinogen - metabolism; Heart attacks; Humans; Laboratories; Lipoproteins; Male; Medical imaging; Middle Aged; Mortality; Myocardial infarction; Percutaneous Coronary Intervention; Prospective Studies; Regression analysis; Risk Factors; Sensitivity and Specificity; Serum Albumin - metabolism; ST Elevation Myocardial Infarction - blood; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - therapy; Studies; Triglycerides; Variables
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2016.03.003

Abstract Objective Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin (SA) 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 SYNTAX Score (SS) in patients with STEMI. Methods 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’s rank correlation coefficient analysis was used for the relationship between FAR and SS. The cut-off points for sensitivity and specificity of FAR in predicting SS were estimated by performing a receiver operator characteristic (ROC) curve analysis. Results There were significant differences in the mean age (p = 0.016), admission SA (p = 0.041), serum fibrinogen (p < 0.001), FAR (p < 0.001), and SS risk groups. Positive correlation was detected between FAR and SS (r = 0.458, p < 0.001). A cut-off level of > 87 FAR predicted SS (sensitivity 70%, specificity 70.%), and an area under curve (AUC) of 0.758 serum fibrinogen and albumin levels were independent predictors for SS in patients with STEMI (b = 0.039, 95% CI:0.016 to 0.062, p = 0.001, b =-6.906, 95% CI:-12.284 to -1.527, p = 0.013 respectively). Conclusion In the present study, we showed that FAR is significantly related to SS in predicting the severity of CAD in patients with STEMI.