Relationship Between the Fibrinogen-to-Albumin Ratio and SYNTAX Score in Patients with Non-St-Elevation Myocardial Infarction

ABSTRACT Background: Despite the association of fibrinogen-to-albumin ratio (FAR) with the extent, severity, and complexity of coronary artery disease (CAD) in patients with ST-elevation myocardial infarction (STEMI) and stable CAD, no studies to date have specifically addressed this issue in patients with non-STEMI (NSTEMI). Objectives: This study aimed to evaluate whether a relationship exists between FAR and the SYNergy between Percutaneous Coronary Intervention with TAXus (SYNTAX) score in patients with NSTEMI. Methods: In this prospective cross-sectional study, 330 patients with NSTEMI who had undergone coronary angiography in an academic medical center were divided into two groups: those with an intermediate/high (≥23) SYNTAX score (241 patients) and those with a low SYNTAX score <23 (89 patients). SYNTAX score was computed by two highly experienced cardiologists (who were blinded to the study data) using an online SYNTAX calculator. Fibrinogen and albumin levels were measured in all patients, and FAR was calculated. Results: Multivariate logistic regression analysis showed that FAR (odds ratio [OR]: 1.478, 95% confidence interval [CI]: 1.089-2.133, p = 0.002), low-density lipoprotein (OR: 1.058, 95% CI: 1.008-1.134, p = 0.026), and troponin I (OR: 1.219, 95% CI: 1.015-1.486, p = 0.031) were independent predictors of the SYNTAX score. In a receiver operating characteristics analysis, a cutoff FAR value of 95.3 had an 83% sensitivity and an 86% specificity (area under the curve [AUC]: 0.84, p < 0.001) for the prediction of SYNTAX scores ≥23 in NSTEMI patients. Conclusion: These results indicate that FAR is a useful tool to predict intermediate-high SYNTAX scores in NSTEMI patients.

Correlation of preoperative fibrinogen-to-plasma albumin ratio with the prognosis of patients with rectal cancer / 西安交通大学学报(医学版)

【Objective】 To explore the correlation of preoperative fibrinogen-to-albumin ratio （FAR） with the clinicopathological characteristics and prognosis of patients with rectal cancer so as to clarify the role of coagulation function and nutritional status in the occurrence and progression of tumors. 【Methods】 We retrospectively analyzed the clinicopathological data of 647 patients with rectal cancer who underwent radical resection in The First Affiliated Hospital of Xi’an Jiaotong University from January 1， 2013 to December 31， 2016. According to the optimal cut-off point value of FAR determined by receiver operating characteristic curve， 647 rectal cancer patients were divided into high FAR level group and low FAR level group. The correlation between different preoperative FAR levels and clinicopathological characteristics of rectal cancer patients was analyzed. Multivariate Cox regression analysis was used to analyze the independent risk factors for the prognosis of rectal cancer patients. R software was used to construct the nomogram， and C index and calibration chart were used to evaluate the prediction efficiency of the nomogram. 【Results】 Preoperative FAR levels had a good predictive value for the prognosis of rectal cancer patients. The area under ROC curve was 0.771， the optimal cut-off point was 0.092， and the Youden index was 0.446. There were statistically significant differences in age， T stage， N stage， TNM stage， preoperative CEA levels and preoperative CA19-9 levels between rectal cancer patients with different preoperative FAR levels （P<0.05）. The overrall survival and disease-free survival of rectal cancer patients with different preoperative FAR levels had statistically significant differences （P<0.05）. In the multivariate analysis， preoperative FAR levels （≥0.092， HR=3.298， 95% CI： 2.365―4.600， P<0.001）， age （≥60 years， HR=2.110， 95% CI： 1.479―3.012， P<0.001）， TNM stage （Ⅲ grade， HR=6.743， 95% CI： 2.771―16.771， P<0.001）， grade of differentiation （poor， HR=1.639， 95% CI： 1.104―2.432，P=0.014）， preoperative CA19-9 levels （≥37 U/mL， HR=2.205， 95% CI： 1.529―3.180， P<0.001） and not perform postoperative chemoradiotherapy（HR=1.792， 95% CI： 1.294―2.480，P<0.001） were independent risk factors of overall survival for patients with rectal cancer. OS and DFS nomograms of rectal cancer were established by the Rlanguage software， and the C-index was （0.781， 95% CI： 0.749―0.815； 0.754， 95% CI： 0.693―0.760）， respectively. The calibration curve of the nomogram showed high consistence between predictions and actual results for 1-year， 3-year， 5-year OS and DFS. 【Conclusion】 The preoperative high FAR level was an independent risk factor for the prognosis of patients with rectal cancer. It can be supplemented with pathological factors such as TNM stage as prognostic indicators for patients with rectal cancer， which may be helpful for clinicians to follow up or make beneficial treatment for rectal cancer patients.

The role of monocyte to HDL ratio in predicting clinically significant carotid stenosis in patients with asymptomatic carotid artery disease

SUMMARY OBJECTIVE Monocyte count to HDL-C Ratio (MHR) and Fibrinogen to Albumin Ratio (FAR) have recently emerged as markers of inflammation in atherosclerotic diseases. Our goal was to investigate the relationships of MHR and FAR with the severity of carotid artery stenosis (CAS) in patients with asymptomatic carotid artery disease. METHODS This retrospective study consisted of 300 patients with asymptomatic CAS. Pre-angiographic MHR, FAR, and high-sensitive C-reactive protein (hsCRP) were measured. Carotid angiography was performed in patients with ≥50% stenosis on carotid ultrasonography. Patients were first split into 2 groups based on the degree of CAS and then tertiles (T) of MHR. RESULTS 96 patients had clinically insignificant CAS (<50%) (Group-1), and 204 patients had clinically significant CAS (≥50%) (Group-2). Group-2 had higher MHR, FAR, and hsCRP than group-1. Patients in T3 had higher MHR, FAR, and hsCRP than in T1 and T2. MHR, FAR, and hsCRP were correlated with each other (p<0.001, for all). MHR, FAR, and hsCRP were independent predictors of significant CAS. MHR better predicted a significant CAS than FAR and hsCRP (p<0.05). CONCLUSION Pre-angiographic MHR may be a better predictor than FAR and hsCRP in identifying a clinically significant carotid stenosis in patients with asymptomatic CAS. Patients with asymptomatic CAS and a high level of MHR should be followed-up closely to supervise risk-factor control and intensify treatment.

RESUMO OBJETIVO Recentemente, a contagem de monócitos para a proporção HDL-C (MHR) e a relação fibrinogênio para albumina (FAR) emergiram como marcadores de inflamação em doenças ateroscleróticas. Nosso objetivo é investigar a relação da MHR e FAR com a gravidade da estenose da artéria carótida (CAS) em pacientes com doença assintomática da artéria carótida. MÉTODOS Este estudo retrospectivo incluiu 300 pacientes com CAS assintomática. MHR pré-angiográfica, FAR e proteína C reativa de alta sensibilidade (hsCRP) foram medidas. A angiografia carotídea foi realizada em pacientes com estenose ≥50% na ultrassonografia carotídea. Os pacientes foram primeiramente divididos em dois grupos com base no grau de CAS e depois nos tercis (T) da MHR. RESULTADOS Noventa e seis pacientes apresentaram um CAS clinicamente insignificante (<50%) (grupo 1) e 204 pacientes apresentaram CAS clinicamente significativo (≥50%) (grupo 2). O grupo 2 apresentou MHR, FAR e hsCRP superior ao grupo 1. Pacientes em T3 apresentaram maior MHR, FAR e hsCRP do que em T1 e T2. MHR, FAR e hsCRP foram correlacionados entre si (p<0,001, para todos). MHR, FAR e hsCRP foram preditores independentes de CAS significativa. MHR predisse melhor uma CAS significativa que FAR e hsCRP (p<0,05). CONCLUSÕES A MHR pré-angiográfica pode ser um melhor preditor que a FAR e a hsCRP na identificação de estenose carotídea clinicamente significativa em pacientes com CAS assintomática. Pacientes com CAS assintomática e alto nível de MHR devem ser acompanhados de perto para supervisionar o controle dos fatores de risco e intensificar o tratamento.

Value of fibrinogen to albumin ratio on predicting spontaneous recanalization of infarct-related artery in patients with acute ST-segment elevation myocardial infarction / 中华心血管病杂志

Objective@#To investigate the value of fibrinogen to albumin ratio (FAR) at admission on predicting spontaneous recanalization of infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI).@*Methods@#Clinical data from 255 acute STEMI patients ((61.1±11.2) years old, 189 males) who underwent emergency coronary angiography within 12 hours in our hospital from December 2015 to April 2018 were retrospectively analyzed. The acute STEMI patients were divided into non-spontaneous recanalization group (thrombolysis in myocardial infarction (TIMI) flow grade 0-1, 203 cases) and spontaneous recanalization group (TIMI flow grade 2-3, 52 cases). Multivariate logistic regression analysis was used to evaluate related factors of IRA spontaneous recanalization. The receiver operating characteristic (ROC) curve was used to evaluate the value of FAR in predicting spontaneous coronary recanalization.@*Results@#There was no significant difference in age,gender, hypertension, diabetes, smoking,systolic blood pressure,diastolic blood pressure,heart rate, duration of chest pain, type of infarction, infarct-related artery, door-to-balloon time, and drug used before admission between non-spontaneous recanalization group and spontaneous recanalization group (all P>0.05). The FAR and high-sensitivity C-reactive protein levels were significantly lower in the spontaneous recanalization group than in the non-spontaneous recanalization group (8.20±1.85 vs. 11.02±2.75, P<0.001; (6.87±3.36) g/L vs. (8.51±3.72) g/L, P=0.004). Multivariate logistic regression analysis showed that FAR (OR=0.492, 95%CI 0.354-0.686, P<0.001), serum uric acid (OR=0.994, 95%CI 0.989-0.999, P=0.018) and high-sensitivity C-reactive protein (OR=0.774, 95%CI 0.614-0.975, P=0.030) were independent negative correlation with spontaneous recanalization of infarct-related artery in patients with acute STEMI. The ROC curve showed that the area under the curve of FAR predicting spontaneous recanalization of infarct-related artery in patients with acute STEMI was 0.807 (95%CI 0.630-0.758, P<0.001), and the diagnostic threshold was 9.26, the sensitivity was 76.9%, the specificity was 75.9%.@*Conclusion@#The level of admission FAR has certain predictive value for spontaneous recanalization of infarct-related arteries in patients with acute STEMI.