Correlation Between Fibrinogen To Albumin Ratio And CHA₂DS₂-VASc Score In Patients With Nonvalvular Atrial Fibrillation

ObjectiveTo explore the relationship between fibrinogen to albumin ratio（FAR）and CHA₂DS₂-VASc score in patients with non-valvular atrial fibrillation.Materials and Methods212 patients with non-valvular atrial fibrillation admitted to our department of cardiology from September 2016 to September 2018 were selected,aged 68.72±11.51.The risk of thromboembolism was evaluated by CHA2DS2-VASc scoring system.There were 59 cases（0 to 1 score）and 153 cases with high group（≥2 score）.Baseline characteristics,FAR,clinical biochemical indicators and characteristics of auxiliary examination results were recorded and compared between groups.At the same time,according to the median FAR level,the differences in the CHA₂DS₂-VASc scores between groups were compared.Pearson correlation analysis and Spearman correlation analysis were used to evaluate the correlation between FAR and various inflammatory markers,cardiac ultrasound indicators and CHA₂DS₂-VASc scores.Multivariate logistic regression was used to screen predictors of CHA₂DS₂-VASc high score（≥2 score）,and receiver operating characteristic curve（ROC）was used to evaluate the predictive value of FAR for CHA₂DS₂-VASc high score.Results1.Patients were divided into low group（<2 score,59 cases）and high group（≥2score,153 cases）according to the CHA2DS2-VASc score.History of diabetes,smoking history,drinking history,body mass index（BMI）,systolic blood pressure,diastolic blood pressure,heart rate,triglycerides,total cholesterol,low-density lipoprotein cholesterol,blood uric acid,mean platelet volume（MPV）,the difference was not statistically significant（P>0.05）;statins,calcium antagonists,beta blockers,and angiotensin converting enzyme inhibitors/angiotensin receptor antagonists were administered between the two groups.The difference was not statistically significant（P>0.05）;the age,female ratio,history of hypertension,history of stroke,neutrophil,lymphocyte,NLR,hemoglobin,red blood cell distribution width between the two groups（RDW）,left ventricular internal diameter（LAD）,fibrinogen,albumin,FAR,high-sensitivity C-reactive protein（hs-CRP）,the difference was statistically significant（P<0.05）;FAR level was significantly higher in the high-group group.Higher than low grouping.2.According to the median FAR level,the patients were divided into low FAR group（FAR<1.13）and high FAR group（FAR≥1.13）.Among the 212 patients in the two groups,27 patients（12.8%）had low risk.There were 30 patients（14.1%）and153 patients（72.1%）with high risk.The CHA₂DS₂-VASc score in the high FAR group was statistically significant compared with the low FAR group（P=0.025）.3.Pearson correlation analysis showed that FAR was positively correlated with NLR（r=0.292,P=0.001）.Spearman correlation analysis showed that FAR was positively correlated with CHA2DS2-VASc score（rs=0.302,P<0.001）.4.Variables with statistically significant differences in univariate analysis,age,gender,history of hypertension,history of diabetes,history of stroke,LAD,white blood cells,neutrophils,lymphocytes,NLR,hemoglobin,fibrinogen,albumin,FAR,RDW were independent variables for multivariate stepwise regression condition logistic regression analysis.The results showed that FAR was one of the independent predictors of CHA₂DS₂-VASc score≥2（OR=1.505,95%CI:1.071².113,P=0.018）.Besides,such as age,gender,hypertension,RDW,NLR are also independent predictors of CHA₂DS₂-VASc score≥2.5.ROC curve results show that the area under the curve of FAR prediction CHA₂DS₂-VASc high score（≥2 points）was 0.709（95%CI:0.643⁰.769,P<0.001）;Yoden index was 0.373,cut-off point was 1.11,sensitivity was 62.75%,specificity was 75.48%.Conclusion1.There is a positive correlation between FAR and CHA₂DS₂-VASc score in patients with non-valvular atrial fibrillation.The higher the FAR level,the higher the CHA₂DS₂-VASc score.2.FAR is an independent factor predicting the high score of CHA₂DS₂-VASc（≥2 points）.High-level FAR may predicts a higher risk of thromboembolism in ischemic stroke.