Objective: To investigate the value of fibrinogen to albumin ratio (FAR) at admission on predicting spontaneous recanalization of infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Clinical data from 255 acute STEMI patients ((61.1±11.2) years old, 189 males) who underwent emergency coronary angiography within 12 hours in our hospital from December 2015 to April 2018 were retrospectively analyzed. The acute STEMI patients were divided into non-spontaneous recanalization group (thrombolysis in myocardial infarction (TIMI) flow grade 0-1, 203 cases) and spontaneous recanalization group (TIMI flow grade 2-3, 52 cases). Multivariate logistic regression analysis was used to evaluate related factors of IRA spontaneous recanalization. The receiver operating characteristic (ROC) curve was used to evaluate the value of FAR in predicting spontaneous coronary recanalization. Results: There was no significant difference in age,gender, hypertension, diabetes, smoking,systolic blood pressure,diastolic blood pressure,heart rate, duration of chest pain, type of infarction, infarct-related artery, door-to-balloon time, and drug used before admission between non-spontaneous recanalization group and spontaneous recanalization group (all P>0.05). The FAR and high-sensitivity C-reactive protein levels were significantly lower in the spontaneous recanalization group than in the non-spontaneous recanalization group (8.20±1.85 vs. 11.02±2.75, P<0.001; (6.87±3.36) g/L vs. (8.51±3.72) g/L, P=0.004). Multivariate logistic regression analysis showed that FAR (OR=0.492, 95%CI 0.354-0.686, P<0.001), serum uric acid (OR=0.994, 95%CI 0.989-0.999, P=0.018) and high-sensitivity C-reactive protein (OR=0.774, 95%CI 0.614-0.975, P=0.030) were independent negative correlation with spontaneous recanalization of infarct-related artery in patients with acute STEMI. The ROC curve showed that the area under the curve of FAR predicting spontaneous recanalization of infarct-related artery in patients with acute STEMI was 0.807 (95%CI 0.630-0.758, P<0.001), and the diagnostic threshold was 9.26, the sensitivity was 76.9%, the specificity was 75.9%. Conclusion: The level of admission FAR has certain predictive value for spontaneous recanalization of infarct-related arteries in patients with acute STEMI.
目的： 探讨入院纤维蛋白原与白蛋白比值（FAR）预测急性ST段抬高型心肌梗死（STEMI）患者梗死相关动脉自发再通的价值。 方法： 回顾性分析2015年12月至2018年4月在郑州大学第二附属医院确诊并在发病12 h内行冠状动脉造影的急性STEMI患者255例。入选患者年龄（61.1±11.2）岁，男性189例，女性66例。根据冠状动脉造影显示梗死相关动脉是否自发再通，将急性STEMI患者分为非自发再通组[梗死相关动脉血流心肌梗死溶栓试验（TIMI）分级为0~1级，203例]和自发再通组（梗死相关动脉血流TIMI分级为2~3级，52例）。采用多因素logistic回归筛选评价梗死相关动脉自发再通的影响因素，采用受试者工作特征（ROC）曲线评价FAR预测梗死相关动脉自发再通的价值。 结果： 非自发再通组与自发再通组患者的年龄、性别、合并高血压、糖尿病、吸烟、收缩压、舒张压、心率、胸痛持续时间、心肌梗死部位、梗死相关动脉、入门-球囊扩张时间和院前用药差异均无统计学意义（P均>0.05）。自发再通组患者FAR和高敏C反应蛋白水平均低于非自发再通组[分别为8.20±1.85比11.02±2.75，P<0.001；（6.87±3.36）g/L比（8.51±3.72）g/L，P=0.004]。多因素logistic回归分析显示，FAR（OR=0.492，95%CI 0.354~0.686，P<0.001）、血尿酸（OR=0.994，95%CI 0.989~0.999，P=0.018）和高敏C反应蛋白（OR=0.774，95%CI 0.614~0.975，P=0.030）与急性STEMI患者梗死相关动脉自发再通呈独立负关联。ROC曲线显示，入院FAR预测急性STEMI患者梗死相关动脉自发再通的曲线下面积为0.807（95%CI 0.630~0.758，P<0.001），诊断临界值为9.26，敏感度为76.9%，特异度为75.9%。 结论： 入院FAR水平对急性STEMI患者梗死相关动脉自发再通有一定的预测价值。.
Keywords: Fibrinogen to albumin ratio; Myocardial infarction; Spontaneous recanalization.