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已发表论文
纤维蛋白原与白蛋白比值与老年冠心病患者长期死亡率之间的关联：一项为期 10 年的前瞻性随访研究
Authors Wu J, Li J, Ping P, Li P, Zhao J, Li B, Zhao Y, Zhang Y, Fu S
Received 13 August 2025
Accepted for publication 1 December 2025
Published 12 December 2025 Volume 2025:20 Pages 2543—2555
DOI https://doi.org/10.2147/CIA.S556641
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Nandu Goswami
Jingwen Wu,1,* Jianyong Li,2,* Ping Ping,3,* Pei Li,4,* Jingxuan Zhao,5,* Bo Li,6 Yali Zhao,7 Youchen Zhang,8 Shihui Fu4,6,9,10
1Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, Hainan, People’s Republic of China; 2Department of Neurology, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 3General Station for Drug and Instrument Supervision and Control, Joint Logistic Support Force of Chinese PLA, Beijing, People’s Republic of China; 4Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, People’s Republic of China; 5School of Biomedical Engineering, Hainan University, Haikou, Hainan, People’s Republic of China; 6Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, Hainan, People’s Republic of China; 7Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 8Department of Pediatrics, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 9Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China; 10The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shihui Fu, Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, Hainan, People’s Republic of China, Email xiaoxiao0915@126.com Youchen Zhang, Department of Pediatrics, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China, Email zangyoujin123@163.com
Background: The synergistic effect of fibrinogen and albumin on long-term mortality remains unclear in senile patients with coronary artery disease (CAD). This study aimed to evaluate the association between fibrinogen-to-albumin ratio (FAR) and 10-year mortality, and to develop a model to predict survival probability in senile patients with CAD.
Methods: In total, 819 senile patients with CAD were enrolled on the basis of the China Geriatric Cardiovascular Comorbidity Study.
Results: Compared with patients in the lowest FAR (FAR-Q1) group, the median overall survival (OS) was 2631 days, and patients in the highest FAR (FAR-Q4) group had the shortest OS, with a median of 311 days (p < 0.0001). Multivariate Cox regression suggested FAR as a crucial factor affecting long-term mortality of patients with CAD (HR = 37.75, 95% CI = 4.10– 347.98; p < 0.05). Five features associated with long-term mortality were selected using Least Absolute Shrinkage and Selection Operator (LASSO) regression: age, hemoglobin, albumin, FAR, and lnNT-proBNP. The area under the receiver operating characteristic curve (AUC) was 0.838 for multivariate Cox regression and 0.829 for LASSO regression. The restricted cubic spline curve showed a significant J-shaped relationship between FAR and mortality, with a cut-off point of 0.09 (p for nonlinear < 0.001). A time-dependent nomogram was constructed based on five features selected using LASSO regression. The time-dependent AUC remained in the range of 0.69– 0.73, indicating the relatively stable power of this model.
Conclusion: FAR was independently associated with long-term mortality, and a prognostic model based on FAR may aid risk stratification in senile patients with CAD.
Plain Language Summary: 1. Coronary artery disease (CAD) is the principal cause of death worldwide and is a huge burden on medical care each year.
2. The synergistic effect of fibrinogen and albumin on long-term mortality remains unclear in senile patients with CAD.
3. This study aimed to evaluate the association between fibrinogen-to-albumin ratio (FAR) and 10-year mortality, and to develop a model to predict survival probability.
4. FAR was independently associated with long-term mortality, with a nonlinear J-shaped relationship between FAR and mortality.
5. This study was the first to construct a prognostic model based on FAR for predicting long-term mortality in senile patients with CAD.
Keywords: coronary artery disease, fibrinogen-to-albumin ratio, J-shaped relationship, long-term mortality, senile patients
1Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, Hainan, People’s Republic of China; 2Department of Neurology, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 3General Station for Drug and Instrument Supervision and Control, Joint Logistic Support Force of Chinese PLA, Beijing, People’s Republic of China; 4Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, People’s Republic of China; 5School of Biomedical Engineering, Hainan University, Haikou, Hainan, People’s Republic of China; 6Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, Hainan, People’s Republic of China; 7Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 8Department of Pediatrics, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China; 9Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China; 10The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shihui Fu, Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, Hainan, People’s Republic of China, Email xiaoxiao0915@126.com Youchen Zhang, Department of Pediatrics, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, People’s Republic of China, Email zangyoujin123@163.com
Background: The synergistic effect of fibrinogen and albumin on long-term mortality remains unclear in senile patients with coronary artery disease (CAD). This study aimed to evaluate the association between fibrinogen-to-albumin ratio (FAR) and 10-year mortality, and to develop a model to predict survival probability in senile patients with CAD.
Methods: In total, 819 senile patients with CAD were enrolled on the basis of the China Geriatric Cardiovascular Comorbidity Study.
Results: Compared with patients in the lowest FAR (FAR-Q1) group, the median overall survival (OS) was 2631 days, and patients in the highest FAR (FAR-Q4) group had the shortest OS, with a median of 311 days (p < 0.0001). Multivariate Cox regression suggested FAR as a crucial factor affecting long-term mortality of patients with CAD (HR = 37.75, 95% CI = 4.10– 347.98; p < 0.05). Five features associated with long-term mortality were selected using Least Absolute Shrinkage and Selection Operator (LASSO) regression: age, hemoglobin, albumin, FAR, and lnNT-proBNP. The area under the receiver operating characteristic curve (AUC) was 0.838 for multivariate Cox regression and 0.829 for LASSO regression. The restricted cubic spline curve showed a significant J-shaped relationship between FAR and mortality, with a cut-off point of 0.09 (p for nonlinear < 0.001). A time-dependent nomogram was constructed based on five features selected using LASSO regression. The time-dependent AUC remained in the range of 0.69– 0.73, indicating the relatively stable power of this model.
Conclusion: FAR was independently associated with long-term mortality, and a prognostic model based on FAR may aid risk stratification in senile patients with CAD.
Plain Language Summary: 1. Coronary artery disease (CAD) is the principal cause of death worldwide and is a huge burden on medical care each year.
2. The synergistic effect of fibrinogen and albumin on long-term mortality remains unclear in senile patients with CAD.
3. This study aimed to evaluate the association between fibrinogen-to-albumin ratio (FAR) and 10-year mortality, and to develop a model to predict survival probability.
4. FAR was independently associated with long-term mortality, with a nonlinear J-shaped relationship between FAR and mortality.
5. This study was the first to construct a prognostic model based on FAR for predicting long-term mortality in senile patients with CAD.
Keywords: coronary artery disease, fibrinogen-to-albumin ratio, J-shaped relationship, long-term mortality, senile patients