The association between fibrinogen-to-albumin ratio (FAR) and adverse prognosis in patients with acute decompensated heart failure at different glucose metabolic states.
The association between fibrinogen-to-albumin ratio (FAR) and adverse prognosis in patients with acute decompensated heart failure at different glucose metabolic states.
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不同糖代谢状态下纤维蛋白原白蛋白比值（FAR）与急性失代偿性心力衰竭患者不良预后的关系
DOI：
10.1186/s12933-022-01662-x
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发表时间：
2022-11-12
影响因子：
9.3
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中科院分区：
文献类型：
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循环纤维蛋白原与白蛋白比率（FAR）已被提议作为一种新型炎症生物标志物和心血管疾病风险预测因子。然而，其对急性失代偿性心力衰竭（ADHF）和不同血糖代谢状态患者的预后价值仍然不明确。该研究共纳入了2018年1月至2021年5月住院的ADHF患者1031例。主要终点是主要不良心脏和大脑事件（MACCE）。根据限制三次样条函数分析获得的 FAR 最佳截断值，将患者分为高水平 FAR (FAR-H) 和低水平 FAR (FAR-L) 组。使用 Kaplan-Meier 图和三个多变量调整的 Cox 比例风险模型来确定 FAR 与处于不同血糖代谢状态的 ADHF 患者发生 MACCE 风险之间的关联。在 520 天的中位随访时间内，有 483 名患者 (46.8%) 发生了 MACCE。最佳 FAR 截止值为 0.079。分析 Kaplan-Meier 图后发现，所有患者和糖尿病患者的 FAR 组之间 MACCE 的发生率存在显着差异 (p<0.05)。调整混杂因素后，与 FAR-L 组相比，FAR-H 组所有患者的 MACCE 风险比 (HR) 为 1.29（模型 3：95% CI 1.07–1.56，p = 0.007）。此外，在三个多元 Cox 模型中，高 FAR 与 MACCE 相关（模型 1，HR = 1.52，95% CI 1.17–1.96，p = 0.002；模型 2，HR = 1.46，95% CI 1.13–1.89，p = 0.004；模型3，DM 患者的 HR = 1.48，95% CI 1.14–1.92，p = 0.003）。但使用三种 Cox 模型，在糖尿病前期 (Pre-DM) 和正常血糖调节 (NGR) 的 FAR 组之间没有发现显着差异（所有 p 值均为 > 0.05）。 FAR 升高与 ADHF 和 DM 患者的不良预后独立相关，因此可以用作风险分层工具和未来的潜在治疗目标。
Circulating fibrinogen-to-albumin ratio (FAR) has been proposed as a novel inflammatory biomarker and a cardiovascular disease risk predictor. However, its prognostic value in patients with acute decompensated heart failure (ADHF) and different glycemic metabolic states remains ambiguous. A total of 1031 hospitalized patients with ADHF from January 2018 to May 2021 were included in the study. The primary endpoints were the major adverse cardiac and cerebral events (MACCEs). Patients were categorized into high-level FAR (FAR-H) and low-level FAR (FAR-L) groups based on the optimal cut-off value of FAR obtained from restricted cubic spline function analysis. The Kaplan–Meier plots and three multivariate-adjusted Cox proportional hazard models were used to determine the association between FAR and the risk of developing MACCEs in patients with ADHF at different glycemic metabolic states. MACCEs occurred in 483 (46.8%) patients during a median follow-up time of 520 days. The optimal FAR cut-off value was 0.079. Upon analyzing the Kaplan–Meier plots, the incidence of MACCEs was significantly different between the FAR groups in all patients and patients with diabetes mellitus (p < 0.05). After adjusting for the confounding factors, the hazard ratio (HR) for MACCEs in the FAR-H group was 1.29 compared with the FAR-L group in all patients (Model 3: 95% CI 1.07–1.56, p = 0.007). Additionally, high FAR was associated with MACCEs in three multivariate Cox models (Model 1, HR = 1.52, 95% CI 1.17–1.96, p = 0.002; Model 2, HR = 1.46, 95% CI 1.13–1.89, p = 0.004; Model 3, HR = 1.48, 95% CI 1.14–1.92, p = 0.003) in DM patients. But no significant differences were found between the FAR groups for prediabetes mellitus (Pre-DM) and normal glucose regulation (NGR) using the three Cox models (all p-values were > 0.05). Elevated FAR was independently associated with poor prognosis in patients with ADHF and DM and thus could be used as a risk stratification tool and a potential therapeutic target in the future.
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影响因子：
--
作者：
Li, Mingkang;Tang, Chengchun;Yan, Gaoliang
通讯作者：
Yan, Gaoliang
影响因子：
2.1
作者：
Duan Z;Luo C;Fu B;Han D
通讯作者：
Han D
影响因子：
3.8
作者：
Ancion A;Allepaerts S;Oury C;Gori AS;Piérard LA;Lancellotti P
通讯作者：
Lancellotti P
影响因子：
2.7
作者：
Liu G;Fan CM;Guo H;Fan WN;Li ML;Cui GX
通讯作者：
Cui GX
影响因子：
37.8
作者：
Mann, DL;McMurray, JJV;Fleming, T
通讯作者：
Fleming, T