European Journal of Cardiovascular Medicine

Background: Coronary Artery Disease (CAD) is one of the topmost causes of morbidity and mortality worldwide. Acute ST-segment elevation myocardial infarction (STEMI) is the most serioustype of CAD. Fibrinogen is an important factor expressed in response to systemic inflammatory and hemorheological alterations. Albumin is an important mediator of plateletinduced coronary artery constriction. Hypoalbuminemia may increase blood viscosity and can alter endothelial function. Fibrinogen-Albumin Ratio (FAR) addressing such pathophysiology of STEMI may provide additional information. This study aims to determine FAR in STEMI patients, correlate FAR with Gensini score based on coronary angiography and predict adverse outcomes of STEMI based on FAR values.  Methods: A cross sectional study in 51 patients with STEMI was conducted over one and a half yearsfrom March 2021 to August 2022. Eligible patients undergoing primary percutaneouscoronaryintervention was subjected to clinical history, physical examination, andinvestigations as per the structured proforma. Categorical data has been represented in theform of frequencies and proportions. Chi-square test or Fischer’s exact test was used as testof significance for qualitative data. Correlations were performed with Pearson Correlationcoefficient. We determined the severity of coronary artery disease based on Gensini scoringsystem. FAR values were correlated with the Gensini score. P-value of <0.05 was considered as statistically significant.  Results: In this study most of the cases (35.3%) were in the age group of 51-60 years with a mean age of 52 ± 14 years, 78.4% were males, 21.6% were females. About 39.2% were found to have single vessel disease, 33.3% had double vessel disease and 27.5% had triple vessel disease. About 60.8% had developed adverse outcomes predominantly heart failure. There was a Positive weak correlation between FAR and Gensini score (Pearson correlation; r = 0.148, P = 0.300) which was not statistically significant. The area under the receiver operating characteristic curve (AUC) for FAR in predicting the outcome is 0.595 (95% CI: 0.449 to 0.730, P = 0.246), with a cut-off of 0.063, with a sensitivity of 70% and specificity of 51.6%.  Conclusion: FAR may not be a substitute for coronary angiography in determining the severity of CAD, butit has some positive correlation with the angiographic severity measured by Gensini score. Though it is not statistically significant, however it can be used as an add-on biomarker along with other parameters in determining the severity of CAD. It is a non-invasive feasible test thatcan be done in a primary or secondary health centre for identifying patients who are at high risk of developing cardiovascular events and initiating appropriate measures.

Background: Coronary Artery Disease (CAD) is one of the topmost causes of morbidity and mortality worldwide. Acute ST-segment elevation myocardial infarction (STEMI) is the most serioustype of CAD. Fibrinogen is an important factor expressed in response to systemic inflammatory and hemorheological alterations. Albumin is an important mediator of plateletinduced coronary artery constriction. Hypoalbuminemia may increase blood viscosity and can alter endothelial function. Fibrinogen-Albumin Ratio (FAR) addressing such pathophysiology of STEMI may provide additional information. This study aims to determine FAR in STEMI patients, correlate FAR with Gensini score based on coronary angiography and predict adverse outcomes of STEMI based on FAR values.  Methods: A cross sectional study in 51 patients with STEMI was conducted over one and a half yearsfrom March 2021 to August 2022. Eligible patients undergoing primary percutaneouscoronaryintervention was subjected to clinical history, physical examination, andinvestigations as per the structured proforma. Categorical data has been represented in theform of frequencies and proportions. Chi-square test or Fischer’s exact test was used as testof significance for qualitative data. Correlations were performed with Pearson Correlationcoefficient. We determined the severity of coronary artery disease based on Gensini scoringsystem. FAR values were correlated with the Gensini score. P-value of <0.05 was considered as statistically significant.  Results: In this study most of the cases (35.3%) were in the age group of 51-60 years with a mean age of 52 ± 14 years, 78.4% were males, 21.6% were females. About 39.2% were found to have single vessel disease, 33.3% had double vessel disease and 27.5% had triple vessel disease. About 60.8% had developed adverse outcomes predominantly heart failure. There was a Positive weak correlation between FAR and Gensini score (Pearson correlation; r = 0.148, P = 0.300) which was not statistically significant. The area under the receiver operating characteristic curve (AUC) for FAR in predicting the outcome is 0.595 (95% CI: 0.449 to 0.730, P = 0.246), with a cut-off of 0.063, with a sensitivity of 70% and specificity of 51.6%.  Conclusion: FAR may not be a substitute for coronary angiography in determining the severity of CAD, butit has some positive correlation with the angiographic severity measured by Gensini score. Though it is not statistically significant, however it can be used as an add-on biomarker along with other parameters in determining the severity of CAD. It is a non-invasive feasible test thatcan be done in a primary or secondary health centre for identifying patients who are at high risk of developing cardiovascular events and initiating appropriate measures.