Predictive Value Of The Fibrinogen/Albumin Ratio （FAR） In In-stent Restenosis After PCI

Objective:We will study the correlation between fibrinogen / albumin ratio（FAR）and in-stent restenosis（ISR）in PCI in coronary heart disease patients,and analyze its predictive value for ISR.Methods:The study belongs to a retrospective case-control study.The study analyzed patients with coronary heart disease who implanted drug-eluting stent（DES）for the first time in the Cardiovascular Disease Center of Yan’an University Hospital from December 2018 to December 2020,and reviewed for coronary angiography or coronary CTA 12 months after surgery.A total of 254 patients were included by inclusion and exclusion criteria,including 96 patients with in-stent restenosis（ISR）and 158 patients in-stent restenosis（NISR）.We collected general patient data,blood biochemical indicators and data on stent implantation treatment data,where came Medical Record Browsing System of the Affiliated Hospital of Yan’an University.Meanwhile,we applied univariate analysis and logistic multivariate regression analysis to identify clinical and laboratory metrics of an association with ISR.Furthermore,The cut off values and diagnostic efficiencies of the parameters that FAR were obtained via receiver operating curve analysis.Results:1.Results Analysis of the medical records of 254 patients with stable angina pectoris,revealed that 96 patients had ISR while 158 did not.The age,gender,hypertension,diabetes mellitus,smoking history did not change in ISR and NISR group（P>0.05）.2.The comparison of the laboratory parameters of the ISR and NISR groups is presented.These lipoprotein cholesterol,lipoproteina α,fibrinogen and fibinogen/albumin ratio were higher in the non-surviving group.The differences were found to be significant（P<0.05）.The The average ALB value among patients with ISR was found to be39.44±4.56 mg/g,which was seen to be significantly lower than for those without ISR for whom it was 41.51±2.34 mg/g P<0.001).Those ischemia modified albumin,total cholestero,triglyceride,high-dentisity lipoprotein cholesterol,uric acid and glycated hemoglobin did not change in ISR and NISR group（P>0.05）.3.Location,mean diameter and number of implanted stents did not show significant differences between ISR and NISR group（P>0.05）.The total length of stent showed a slight increase from NISR to the ISR group,p < 0.05 was considered as statistically significant.We compare the two groups between bifurcation and multibranch lesions in the coronary lesions,The measurements showed significant differences（P<0.05）.However,the FAR were not significantly different in the bifurcation lesions and multibranch disease in the ISR components.4.There was no significant difference in the postoperative medication status between the two groups.5.The ROC curve for FAR in predicting the presence of ISR had an area under the curve of 0.766（95%CI:0.706-0.826,P<0.05）.On calculating the Youden index,a FAR cut off value of 6.93 was seen to have the best predictability for ISR with a sensitivity of63.5% and a specificity of 78.5%.6.We performed on LDL-C,Lipoprotein α,FAR,mean diameter of stents,bifurcation lesions,multibranch disease,hypertension,diabetes and smoking.However,on logistic regression analysis,only two variables had an independent association with the presence of ISR,namely FAR（β=0.580,P=0.001,OR=1.787,95%CI=1.399-2.283）and Lp（α）（β=0.756,P=0.019,OR=2.130,95%CI=1.133-4.006）.Conclusion:1.FAR is clearly associated with the occurrence of ISR after DES implantation;it is an independent risk factor for ISR after DES implantation;2.when FAR is> 6.93,it can be used as a predictive ISR biomarker to identify people at high risk of ISR.