Effect Of Serum Fibrinogen/Albumin Ratio On The Prognosis Of Young And Middle-aged Male Patients With AMI

Objective: The purpose of this study was to investigate the changes of Fibrinogen/albumin ratio(FAR)in young and middle-aged male patients with acute myocardial infarction(AMI),to analyze the difference of FAR in different types of AMI and its relationship with the degree of coronary artery disease,and to explore the effect of FAR on the prognosis of young and middle-aged male patients with AMI treated by Percutaneous Coronary Intervention(PCI).Methods: 1.This study included 290 young and middle-aged male patients aged ≤59 and finally diagnosed as AMI in the Department of Cardiology,the second affiliated Hospital of Dalian Medical University from January 2019 to December 2021.They were divided into two groups: ST segment elevation myocardial infarction(STEMI)group and non-ST segment elevation myocardial infarction(NSTEMI)group.At the same time,136 patients with Non-Coronary heart disease(Non-CHD)who were negative by Coronary angiography(CAG)were selected as the control group.2.The data of fibrinogen(Fib)and albumin(Alb)were collected,and FAR was calculated to observe the changes of FAR in the three groups.3.The correlation between Fib,Alb,FAR and SYNTAX score was analyzed by Spearman correlation.4.According to the occurrence of major adverse cardiovascular events(MACE),the patients in AMI group were divided into non-MACE group(n = 256cases)and MACE group(n = 34 cases).The differences of clinical data between the two groups were compared.5.After univariate Logistic regression analysis,the statistically significant indexes in MACE grouping were included in multivariate binary Logistic regression,and the independent risk factors of MACE were analyzed.The Receiver operator characteristic curve(ROC)was used to analyze the predictive value of FAR in young and middle-aged male patients with AMI after PCI.Results: 1.Compared with Non-CHD group,the levels of fasting blood glucose(FPG),Hb A1 c,Fib and FAR in STEMI group and NSTEMI group were higher than those in Non-CHD group,while the level of Alb was lower than that in Non-CHD group(all P<0.001),but there was no significant difference between STEMI group and NSTEMI group(all P>0.05).The levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in STEMI group,NSTEMI group and Non-CHD group decreased gradually,and there were significant differences between the three groups(all P<0.001).There was no significant difference in age among the three groups(all P>0.05).2.The scores of Fib and FAR were positively correlated with the scores of SYNTAX(r = 0.263,0.267,all P<0.001),but there was no correlation between Alb and SYNTAX(r=-0.092,P>0.05).3.Compared with the group without MACE,the proportion of left anterior descending artery(LAD)involved,the proportion of three branches involved and SYNTAX score in MACE group were significantly higher(all P<0.05).In MACE group,the levels of leukocyte,Cardiac troponin I(c Tn I),creatine kinase MB(CK-MB),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-pro BNP),ALT,AST,FPG,Hb A1 c,Fib and FAR were higher,while Triglyceride(TG)and left ventricular ejection fraction(LVEF)were lower(all P<0.05).There was no significant difference in the levels of hemoglobin,platelet,Gamma-glutamyl transferase(GGT),Alb,serum creatinine(Scr),uric acid(UA),Total cholesterol(TC),High density liptein cholesterol(HDL-C)and Low-density lipoprotein cholesterol(LDL-C)between the two groups(all P>0.05).4.Binary multivariate Logistic regression analysis was used to analyze the indexes in MACE group which were statistically significant after univariate Logistic regression analysis.The results showed that SYNTAX score [OR=1.121,95% CI(1.061,1.186),P<0.001],FAR [OR=1.022,95% CI(1.003,1.042)P=0.021],LVEF [OR=0.748,95% CI(0.673,0.832).P <0.001] is an independent risk factor for MACE in young and middleaged male patients with AMI after PCI.5.The ROC curve showed that the area under the curve(AUC)of FAR,SYNTAX score and LVEF for predicting the occurrence of MACE after PCI in young and middleaged men with AMI were 0.719 [95% CI(0.629,0.809),P <0.001],0.861 [95% CI(0.8020.920),P <0.001],0.797 [95% CI(0.697 0.896),P <0.001],that is,they all had certain predictive value for the occurrence of MACE after PCI in young and middle-aged men with AMI.Conclusions: 1.Serum FAR increased significantly during AMI and correlated with the severity of coronary artery disease.2.Serum FAR,SYNTAX score and LVEF are independent risk factors for MACE in young and middle-aged male patients with AMI after PCI,and all of them have certain predictive value for the prognosis of AMI patients.