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纤维蛋白原/白蛋白比值对多支冠状动脉慢性闭塞病变的预测价值
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Abstract:
目的：探究新型炎性标志物纤维蛋白原/白蛋白比值(fibrinogen to albumin ratio, FAR)对多支冠状动脉慢性完全闭塞病变(multivessel-chronic total occlusion, MVCTO)的预测价值。方法：回顾性分析2020年01月至2021年12月青岛大学附属烟台毓璜顶医院心血管内科收治的137例CTO患者的临床资料，根据冠脉造影结果分为单支闭塞病变组(61例)，多支(双支及以上)闭塞病变组(76例)，采用单因素及多因素logistic回归分析，探究MVCTO的独立预测因子，采用ROC曲线分析其预测价值。结果：FAR值升高(OR = 4.237, 95% CI: 2.341~7.668, P < 0.001)及血尿酸升高(OR = 1.007, 95% CI: 1.002~1.012, P = 0.010)是MVCTO的独立预测因子，FAR最佳诊断截值为0.0773，敏感性为82.9%，特异性为68.9%；血尿酸最佳诊断截值为329.5 mmol/L，敏感性为68.4%，特异性为73.8%。结论：FAR对MVCTO病变具有较好的预测价值，对识别高危CTO患者、制定个体化诊疗方案具有指导意义。
OBJECTIVE: To investigate the predictive value of fibrinogen-to-albumin ratio (FAR) for the mul-tivessel-coronary chronic total occlusion (MVCTO). METHODS: The clinical data of 137 CTO patients admitted to the Department of Cardiology of Yantai Yuhuangding Hospital Affiliated to Qingdao University from January 2020 to December 2021 were retrospectively analyzed. The patients were divided into single-vessel CTO group (n = 61) and multivessel CTO group (n = 76) according to coro-nary angiography. Univariate and multivariate logistic regression analyses were used to determine the independent predictors for the MVCTO. Receiver operating characteristic curves were used to determine their predictive power. RESULTS: FAR (OR = 4.237, 95% CI: 2.341~7.668, P < 0.001) and serum uric acid (SUA) (OR = 1.007, 95% CI: 1.002~1.012, P = 0.010) were independent predictors for the MVCTO patients. A cut-off value of 0.0773 in FAR provided a sensitivity of 82.9% and a speci-ficity of 68.9%. A cut-off value of 329.5 mmol/L in SUA provided a sensitivity of 68.4% and a speci-ficity of 73.8%. CONCLUSION: FAR may have a good predictive value for the multivessel lesions in CTO patients, which helps to select the high-risk population and develop individualized treatment plans.
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