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Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary
Yalin Cheng1, Huimin Li2, Chenguang Yang1
1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Insights
The fibrinogen-to-albumin ratio (FAR) is linked to higher mortality in elderly patients (≥80 years) undergoing percutaneous coronary intervention (PCI). Higher FAR levels predict increased cardiovascular and all-cause mortality in this high-risk group.
Area of Science:
- Geriatric Cardiology
- Cardiovascular Research
- Inflammatory Markers
Background:
- The fibrinogen-to-albumin ratio (FAR) is a novel inflammatory marker with prognostic value in cardiovascular diseases.
- Its utility in risk stratification for very elderly patients (≥80 years) undergoing percutaneous coronary intervention (PCI) is not well-established.
Purpose of the Study:
- To investigate the association between the fibrinogen-to-albumin ratio (FAR) and mortality outcomes in oldest-old patients (≥80 years) undergoing PCI.
- To evaluate FAR as a potential risk stratification tool in geriatric cardiology.
Main Methods:
- A retrospective cohort study included 641 patients aged ≥80 years who underwent PCI.
- Patients were stratified into higher and lower FAR groups based on the median value (0.079).
- Multivariable Cox models and restricted cubic splines were used to analyze associations with cardiovascular and all-cause mortality.
Main Results:
- Higher FAR levels were significantly associated with increased cardiovascular and all-cause mortality (log-rank p < 0.001).
- The association between FAR and mortality exhibited a J-shaped curve.
- Higher FAR independently predicted cardiovascular mortality (adjusted HR = 1.49) and was associated with increased cardiovascular mortality risk in triple-vessel disease patients.
Conclusions:
- Elevated FAR levels are associated with increased cardiovascular and all-cause mortality in elderly patients undergoing PCI.
- FAR shows potential as a valuable marker for risk stratification in geriatric cardiovascular care.
Background:
The fibrinogen-to-albumin ratio (FAR), a novel inflammatory marker, has demonstrated prognostic utility in cardiovascular diseases. However, its role in risk stratification among oldest-old patients (≥ 80 years) undergoing percutaneous coronary intervention (PCI) remains poorly established.
Methods:
This single-center retrospective cohort study enrolled 641 consecutive patients aged ≥ 80 years with coronary artery disease who underwent PCI between 2015 and 2021. Based on the median FAR value (0.079), patients were divided into higher FAR and lower FAR groups. The endpoints were cardiovascular and all-cause mortality. Multivariable Cox models and restricted cubic splines assessed the associations between FAR and endpoints.
Results:
During a median follow-up of 61 months, 237 deaths (37%) were recorded, of which, 124 (19.3%) were due to cardiovascular disease. The 1-year mortality was 9.3% and 5-year mortality was 27.4%. Kaplan-Meier analysis demonstrated higher FAR levels were significantly associated with increased risk of both cardiovascular and all-cause mortality (log-rank p < 0.001). According to the restricted cubic spline, the association between FAR and mortality was J-shaped. Higher FAR (> 0.079) independently predicted cardiovascular mortality (adjusted HR = 1.49, 95% CI:1.01-2.19, p = 0.045). When tested as a continuous variable, higher FAR levels were associated with a higher risk of cardiovascular (HR = 1.23, 95% CI: 1.04-1.47, p = 0.018) and all-cause mortality (HR = 1.12, 95%CI: 0.98-1.27, p = 0.090) in fully adjusted models. Subgroup analysis revealed that the association between higher FAR levels and increased cardiovascular mortality was significantly stronger in patients with triple-vessel disease (interaction p = 0.039). The associations between FAR and cardiovascular mortality remained robust in the Fine and Gray competing models (HR = 1.31, 95%CI: 1.13-1.52, p = 0.003).
Conclusion:
Higher FAR levels are associated with increased risks of cardiovascular and all-cause mortality in oldest-old patients undergoing PCI. These findings support the potential of FAR for risk stratification in geriatric cardiology.
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