Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention

Abstract Background The fibrinogen-to-albumin ratio (FAR), a novel inflammatory marker, has demonstrated prognostic utility in cardiovascular diseases. However, its role in risk stratification among oldest-old patients (≥ 80 years) undergoing percutaneous coronary intervention (PCI) remains poorly e...

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Main Authors: Yalin Cheng, Huimin Li, Chenguang Yang, Haiyang Gao, Peng Li, Wanrong Zhu, Yuzhu Lu, Fusui Ji, Xue Yu, Wenduo Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06111-4
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author Yalin Cheng
Huimin Li
Chenguang Yang
Haiyang Gao
Peng Li
Wanrong Zhu
Yuzhu Lu
Fusui Ji
Xue Yu
Wenduo Zhang
author_facet Yalin Cheng
Huimin Li
Chenguang Yang
Haiyang Gao
Peng Li
Wanrong Zhu
Yuzhu Lu
Fusui Ji
Xue Yu
Wenduo Zhang
author_sort Yalin Cheng
collection DOAJ
description Abstract Background The fibrinogen-to-albumin ratio (FAR), a novel inflammatory marker, has demonstrated prognostic utility in cardiovascular diseases. However, its role in risk stratification among oldest-old patients (≥ 80 years) undergoing percutaneous coronary intervention (PCI) remains poorly established. Methods This single-center retrospective cohort study enrolled 641 consecutive patients aged ≥ 80 years with coronary artery disease who underwent PCI between 2015 and 2021. Based on the median FAR value (0.079), patients were divided into higher FAR and lower FAR groups. The endpoints were cardiovascular and all-cause mortality. Multivariable Cox models and restricted cubic splines assessed the associations between FAR and endpoints. Results During a median follow-up of 61 months, 237 deaths (37%) were recorded, of which, 124 (19.3%) were due to cardiovascular disease. The 1-year mortality was 9.3% and 5-year mortality was 27.4%. Kaplan-Meier analysis demonstrated higher FAR levels were significantly associated with increased risk of both cardiovascular and all-cause mortality (log-rank p < 0.001). According to the restricted cubic spline, the association between FAR and mortality was J-shaped. Higher FAR (> 0.079) independently predicted cardiovascular mortality (adjusted HR = 1.49, 95% CI:1.01–2.19, p = 0.045). When tested as a continuous variable, higher FAR levels were associated with a higher risk of cardiovascular (HR = 1.23, 95% CI: 1.04–1.47, p = 0.018) and all-cause mortality (HR = 1.12, 95%CI: 0.98–1.27, p = 0.090) in fully adjusted models. Subgroup analysis revealed that the association between higher FAR levels and increased cardiovascular mortality was significantly stronger in patients with triple-vessel disease (interaction p = 0.039). The associations between FAR and cardiovascular mortality remained robust in the Fine and Gray competing models (HR = 1.31, 95%CI: 1.13–1.52, p = 0.003). Conclusion Higher FAR levels are associated with increased risks of cardiovascular and all-cause mortality in oldest-old patients undergoing PCI. These findings support the potential of FAR for risk stratification in geriatric cardiology.
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spelling doaj-art-9257e38f2a674a7bb4eb2bffd98958d82025-08-20T03:04:15ZengBMCBMC Geriatrics1471-23182025-07-0125111010.1186/s12877-025-06111-4Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary interventionYalin Cheng0Huimin Li1Chenguang Yang2Haiyang Gao3Peng Li4Wanrong Zhu5Yuzhu Lu6Fusui Ji7Xue Yu8Wenduo Zhang9Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesAbstract Background The fibrinogen-to-albumin ratio (FAR), a novel inflammatory marker, has demonstrated prognostic utility in cardiovascular diseases. However, its role in risk stratification among oldest-old patients (≥ 80 years) undergoing percutaneous coronary intervention (PCI) remains poorly established. Methods This single-center retrospective cohort study enrolled 641 consecutive patients aged ≥ 80 years with coronary artery disease who underwent PCI between 2015 and 2021. Based on the median FAR value (0.079), patients were divided into higher FAR and lower FAR groups. The endpoints were cardiovascular and all-cause mortality. Multivariable Cox models and restricted cubic splines assessed the associations between FAR and endpoints. Results During a median follow-up of 61 months, 237 deaths (37%) were recorded, of which, 124 (19.3%) were due to cardiovascular disease. The 1-year mortality was 9.3% and 5-year mortality was 27.4%. Kaplan-Meier analysis demonstrated higher FAR levels were significantly associated with increased risk of both cardiovascular and all-cause mortality (log-rank p < 0.001). According to the restricted cubic spline, the association between FAR and mortality was J-shaped. Higher FAR (> 0.079) independently predicted cardiovascular mortality (adjusted HR = 1.49, 95% CI:1.01–2.19, p = 0.045). When tested as a continuous variable, higher FAR levels were associated with a higher risk of cardiovascular (HR = 1.23, 95% CI: 1.04–1.47, p = 0.018) and all-cause mortality (HR = 1.12, 95%CI: 0.98–1.27, p = 0.090) in fully adjusted models. Subgroup analysis revealed that the association between higher FAR levels and increased cardiovascular mortality was significantly stronger in patients with triple-vessel disease (interaction p = 0.039). The associations between FAR and cardiovascular mortality remained robust in the Fine and Gray competing models (HR = 1.31, 95%CI: 1.13–1.52, p = 0.003). Conclusion Higher FAR levels are associated with increased risks of cardiovascular and all-cause mortality in oldest-old patients undergoing PCI. These findings support the potential of FAR for risk stratification in geriatric cardiology.https://doi.org/10.1186/s12877-025-06111-4Coronary artery diseaseMortalityFibrinogenAlbumin
spellingShingle Yalin Cheng
Huimin Li
Chenguang Yang
Haiyang Gao
Peng Li
Wanrong Zhu
Yuzhu Lu
Fusui Ji
Xue Yu
Wenduo Zhang
Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
BMC Geriatrics
Coronary artery disease
Mortality
Fibrinogen
Albumin
title Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
title_full Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
title_fullStr Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
title_full_unstemmed Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
title_short Fibrinogen-to-albumin ratio and long-term mortality in oldest-old patients undergoing percutaneous coronary intervention
title_sort fibrinogen to albumin ratio and long term mortality in oldest old patients undergoing percutaneous coronary intervention
topic Coronary artery disease
Mortality
Fibrinogen
Albumin
url https://doi.org/10.1186/s12877-025-06111-4
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