| Objective:In recent years,the incidence of coronary heart disease and atrial fibrillation is on the rise,and the coexistence of coronary heart disease and atrial fibrillation is not uncommon in clinical practice,and the prognosis of patients with combined coronary heart disease and atrial fibrillation is often worse.Numerous studies have shown that inflammation is associated with coronary heart disease and atrial fibrillation.Both fibrinogen and albumin are acute phase reactive proteins,which are effective indicators for the prediction of inflammation and can reliably predict the occurrence and development of cardiovascular diseases.Fibrinogen to albumin ratio(FAR),as a compound indicator of inflammation,has been confirmed to be associated with the occurrence and prognosis of coronary heart disease and atrial fibrillation,but its prognostic value for patients with combined coronary heart disease and atrial fibrillation is rarely studied at home and abroad.The purpose of this study was to observe whether FAR was correlated with major adverse cardiovascular events in patients with combined coronary heart disease and atrial fibrillation within 1 year after discharge.Methods:We collected a total of 560 patients with combined coronary heart disease and atrial fibrillation who were admitted to the Cardiology Department of the second Hospital of Dalian Medical University from September 01,2020 to October 31,2021,of whom197 met the inclusion criteria.Firstly,patients were divided into event group and no event group according to whether major adverse cardiovascular events occurred within 1 year after discharge.Baseline data of the two groups were compared to analyze the differences between the two groups.Univariate and multivariate COX proportional hazards models were used to further investigate the independent predictors of major adverse cardiovascular events in patients with combined coronary heart disease and atrial fibrillation.And The optimal cut-off value was found by plotting the receiver operating characteristic(ROC)curve based on the FAR value and the occurrence of the major adverse cardiovascular events.According to the optimal cut-off value,patients were divided into two groups(high FAR group and low FAR group),and the basic data differences between the high FAR group and the low FAR group were compared.Kaplan-Meier survival curve was further used to compare the incidence of major adverse cardiovascular events between the high and low FAR groups.Results:1.Patients were divided into event and no-event groups according to whether they had an major adverse cardiovascular events within 1 year of discharge.The differences in FAR,neutrophil to lymphocyte ratio(NLR),fibrinogen,troponin I,body weight,lymphocyte count,albumin,and left ventricular ejection fraction between the two groups were statistically significant(P<0.05).2.All patients’basic data were substituted into univariate COX regression,and statistically significant indicators were substituted into multivariate COX regression analysis.The results showed that FAR was an independent predictor of major adverse cardiovascular events in patients with combined coronary heart disease and atrial fibrillation(HR:1.212,95%CI:1.076-1.375,p=0.002).In addition,body weight was an independent predictor of major adverse cardiovascular events in patients with combined coronary heart disease and atrial fibrillation(HR:0.967;95%CI:0.936-0.998;P=0.04).3.ROC curve was drawn according to the occurrence of FAR and endpoint events,and it was obtained that when the optimal cut-off value was 8.27,FAR had the highest predictive value for major adverse cardiovascular events.The area under the curve was0.682(95CI%:0.5966-0.767,P=0.000),the sensitivity was 79.5%,and the specificity was 55.1%.In addition,fibrinogen also has a certain predictive value for major adverse cardiovascular events.4.All patients were divided into two groups,the low FAR group(FAR≤8.27)and the high FAR group(FAR>8.27),according to the best cut-off value of FAR.Major adverse cardiovascular events occurred in 31 cases(30.4%)in the high FAR group and 8cases(8.4%)in the low FAR group,the incidence of major adverse cardiovascular events in the high FAR group was significantly higher than that in the low FAR group.and the differences were statistically significant(P=0.000).5.Kaplan-Meier survival curves were plotted and log-rank tests were used to compare the occurrence of major adverse cardiovascular events between patients in the high FAR and low FAR groups.The results showed that the incidence of major adverse cardiovascular events was higher in the high FAR group than in the low FAR group,and the difference was statistically significant(X~2=15.195,Log Rank P=0.000).Conclusion:FAR has a predictive value for the prognosis of patients with combined coronary heart disease and atrial fibrillation,the higher the FAR,the worse the prognosis,and it is an independent predictor of major adverse cardiovascular events within 1 year of discharge. |
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