The impact of preoperative fibrinogen-albumin ratio on mortality in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background: We investigated the prognostic value of fibrinogen-albumin ratio (FAR) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) based on inflammation and hemorheology alterations and to determine whether FAR can supplement incremental predictive information to the Global Registry of Acute Coronary Events (GRACE) score. Methods: We retrospectively analyzed 475 STEMI patients undergoing pPCI. Kaplan-Meier curve, Cox proportional hazards regression model, and Hosmer-Lemeshow test were used to evaluate the prognostic value of FAR in the patients. Results: Patients were assigned to groups of high FAR (>= 0.080) vs low FAR (< 0.080) based on the optimal cutoff value of 0.080. In all, 59 patients (12.4%) died; the mortality rate was higher in high FAR patients than in low FAR patients (20.5% vs. 8.6%, p <.001). FAR positively correlated with C-reactive protein, GRACE score, and Gensini score (p < .001). On multivariate analysis, FAR was an independent prognostic factor in STEMI patients undergoing pPCI. Accordingly, adding FAR to the GRACE score improved the C-index, net reclassification index, and integrated discrimination improvement. Conclusions: Preoperative FAR is an independent prognostic factor in STEMI patients undergoing pPCI and might improve risk stratification in STEMI.