Fibrinogen-to-albumin ratio as a novel biomarker for risk assessment in clinically suspected acute myocarditis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-09-07 DOI:10.1016/j.ijcha.2025.101791

Lihi Levi-Gofman , Shaul Atar , Gassan Moady

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引用次数: 0

Abstract

Background

Acute myocarditis typically follows a benign course, but fatal complications may occur in fulminant cases. Evaluation is based on clinical, laboratory, and imaging parameters. We aimed to assess the prognostic value of the fibrinogen-to-albumin ratio (FAR) in patients with clinically suspected myocarditis.

Methods

Echocardiographic, laboratory, and clinical parameters were obtained from patients with clinically suspected myocarditis. We assessed the correlations between troponin, albumin, fibrinogen, FAR, left ventricular ejection fraction (LVEF), and complications during the index hospitalization. Repeat echocardiography was performed in patients with reduced LVEF. Several potential factors were tested for their ability to predict LVEF recovery.

Results

A total of 118 patients were included (80 % male; median age, 35 years; mean LVEF, 55 %). Median troponin level was 2558 ng/L, and the median fibrinogen-to-albumin ratio (FAR) was 120. In 38 patients (32 %), LVEF was reduced; among them, 15 (39 %) had persistently reduced LVEF on repeat echocardiography. Troponin levels and FAR were inversely correlated with reduced LVEF (r = –0.28, p = 0.002 and r = –0.31, p = 0.001, respectively). FAR remained an independent factor after adjustment for age and sex. Neither troponin nor FAR was associated with persistently reduced LVEF on follow-up echocardiography. In addition, high FAR was not correlated with longer length of stay (LOS) (p = 0.07), readmissions (p = 0.29), or complications during hospitalization (p = 0.22).

Conclusion

FAR is associated with reduced LVEF and may reflect disease severity in clinically suspected myocarditis; however, it does not appear to be useful for long-term prediction.

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纤维蛋白原与白蛋白比值作为临床疑似急性心肌炎风险评估的新生物标志物

背景：急性心肌炎通常是良性的，但暴发性病例可能出现致命的并发症。评估基于临床、实验室和影像学参数。我们的目的是评估纤维蛋白原与白蛋白比（FAR）在临床疑似心肌炎患者中的预后价值。方法收集临床疑似心肌炎患者的心电图、实验室及临床资料。我们评估了肌钙蛋白、白蛋白、纤维蛋白原、FAR、左心室射血分数（LVEF）与住院期间并发症的相关性。对LVEF降低的患者进行重复超声心动图检查。测试了几个潜在因素预测LVEF恢复的能力。结果共纳入118例患者，其中男性80%，中位年龄35岁，平均LVEF 55%。肌钙蛋白水平中位数为2558 ng/L，纤维蛋白原/白蛋白比中位数为120。38例（32%）患者LVEF降低；其中15例（39%）重复超声心动图显示LVEF持续降低。肌钙蛋白水平和FAR与LVEF降低呈负相关（r = -0.28, p = 0.002和r = -0.31, p = 0.001）。在调整了年龄和性别后，FAR仍然是一个独立的因素。随访超声心动图显示，肌钙蛋白和FAR均与LVEF持续降低无关。此外，高FAR与较长的住院时间（LOS）（p = 0.07）、再入院（p = 0.29）或住院期间的并发症（p = 0.22）无关。结论far与LVEF降低相关，可反映临床疑似心肌炎患者病情严重程度；然而，它似乎对长期预测并不有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.