Role of fibrinogen, albumin and fibrinogen to albumin ratio in determining angiographic severity and outcomes in acute coronary syndrome

Table 1 Baseline characteristics and laboratory profile of patients with acute coronary syndrome, n (%)

	STEMI (n = 95)	NSTEMI (n = 38)	USA (n = 33)	P value
Risk factors
Age, yr (mean ± SD)	61.2 ± 10.1	60.2 ± 11.0	60.5 ± 10.5	0.5
Males	73 (76.8)	25 (65.8)	25 (75.8)	0.5
Diabetes	49 (52)	20 (52.6)	14 (42.4)	0.5
Hypertension	61 (64)	22 (58)	21 (64)	0.8
Smoking	31 (32.6)	12 (31.6)	10 (30.3)	0.9
Prior history of CAD	2 (2.2)	6 (16.2)	9 (27.3)	0.001
Clinical features on presentation
Rest angina	89 (93.6)	36 (94.7)	26 (78.8)	0.013
Ejection fraction < 30%	42 (44.2)	10 (26.3)	5 (15.2)	0.005
Significant ischemic MR	30 (31.6)	9 (23.7)	2 (6.1)	0.014
Killip class ≥ 2	24 (25.3)	7 (18.4)	2 (6)	0.057
SCAI stage C	11 (11.6)	7 (18.4)	0	0.04
SCAI stage D	3 (3.2)	0	0	0.3
SCAI stage E	5 (5.3)	0	0	0.14
Key investigations
Creatinine, mg/dL (mean ± SD)	1.17 ± 0.6	1.2 ± 0.6	1.05 ± 0.47	0.42
CK-MB, (mean ± SD)	112 ± 98	71 ± 57	25 ± 24	0.001
Fibrinogen, gm/L (mean ± SD)	6.3 ± 1.2	5.3 ± 1.1	5.3 ± 1.3	0.001
Albumin, gm/dL (mean ± SD)	3.3 ± 0.33	3.4 ± 0.36	3.5 ± 30	0.075
FAR (mean ± SD)	19.1 ± 4.8	15.4 ± 4.0	15.1 ± 4.3	0.001

CAD: Coronary artery disease; MR: Mitral regurgitation; CK-MB: Creatinine kinase; FAR: Fibrinogen to albumin ratio; SCAI: Society of Cardiovascular angiography and Intervention; STEMI: ST elevation myocardial infarction; NSTEMI: Non-ST elevation myocardial infarction; USA: Unstable angina.

Table 2 Comparison between patients with total occlusion of culprit artery compared to patients with > thrombolysis in myocardial infarction 2 flow

	Patients with TIMI- ≤ 1 flow (n = 54)	Patients with TIMI- ≥ 2 flow (n = 98)	P value
Age, yr	60.5 ± 10.2	60.5 ± 10.7	0.9
Time of presentation to hospital after chest pain onset (h)	13.4 ± 11.2	12.3 ± 8.8	0.24
Hypertension	33 (61)	71 (65)	0.3
Active smokers	16 (29.6)	36 (32.4)	0.3
EF < 30%	23 (42.6)	33 (29.7)	0.1
Cardiogenic shock	10 (18.5)	15 (13.5)	0.4
Complete heart block	8 (14.8)	7 (6.3)	0.07
Time to initiation of medical treatment, h	77.3 ± 63	74.5 ± 66	0.87
Time to angiography, h	107 ± 79	113 ± 141	0.84
CK-MB	101.2 ± 90	75 ± 83.4	0.11
Platelet (× 109/L)	1.89 ± 0.7	2.0 ± 0.91	0.17
Procalcitonin (ng/mL)	0.59 ± 0.7	1.0 ± 2.6	0.27
TLC (× 109/L)	10.6 ± 3.8	10.7 ± 3.9	0.8
CRP (mg/dL)	47.2 ± 34.3	39.7 ± 28.4	0.16
Fibrinogen (gm/L)	6.9 ± 1.04	5.4 ± 1.2	0.001
Albumin (gm/dL)	3.3 ± 0.35	3.4 ± 0.32	0.014
FAR	21.1 ± 3.9	15.6 ± 4.1	0.001

EF: Ejection fraction; CK-MB: Creatinine kinase; TLC: Total leukocyte count; FAR: Fibrinogen to albumin ratio; CRP: C-reactive protein; TIMI: Thrombolysis in myocardial infarction.