Fibrinogen/Albumin Ratio is Associated with the Occurrence of Contrast-Induced Acute Kidney Injury in Patients with Congestive Heart Failure

GuangHui Zhang,1 Dehua Huang,1 Jieyi Chen,1 Xi Yang,1 Huangtao Ruan,2 Xiaoyu Huang3 1First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China; 2Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, People’s Republic of China; 3Cardiovascular Intensive Care Unit, Yangjiang Hospital of Guangdong Medical University, Yangjiang, Guangdong, People’s Republic of ChinaCorrespondence: Xiaoyu Huang, Cardiovascular Intensive Care Unit, Yangjiang Hospital of Guangdong Medical University, Yangjiang, Guangdong, People’s Republic of China, Email [email protected]: Patients with congestive heart failure (CHF) are associated with an elevated risk of mortality and poor prognosis. Contrast-induced acute kidney injury (CI-AKI), a common complication in CHF patients undergoing contrast-enhanced procedures, exacerbates renal dysfunction and contributes to adverse outcomes. However, the relationship between the preoperative fibrinogen/albumin ratio (FAR) and the risk of CI-AKI or all-cause mortality in CHF remains unclear. This study analyzed the correlation of FAR with the risk of CI-AKI and all-cause mortality in patients with CHF.Patients and Methods: In this retrospective observational study, CHF patients undergoing coronary angiography (CAG) were enrolled and grouped according to their FAR quartiles. The association between FAR and clinical outcomes was assessed using the multivariate logistic regression and restricted cubic spline (RCS) analyses.Results: This study included 7,235 CHF patients with a mean age of 65.8 ± 11.7 years. Among these, 2,100 were female (29.0%), and 1,094 (15.1%) experienced CI-AKI. FAR showed a non-linear relationship with CI-AKI (p < 0.001). The risk of CI-AKI was significantly higher with increasing FAR. After adjusting for all the potential confounding variables, the risk of CI-AKI was highest in patients with FAR > 0.150 (OR = 1.572, 95% CI 1.237– 2.004, p < 0.001). Multivariate COX proportional risk model showed that the risk of all-cause mortality was highest in CHF patients with FAR > 0.150 (HR = 1.20, 95% CI 1.04– 1.38, p = 0.014).Conclusion: FAR is an independent risk factor for the occurrence of CI-AKI in patients with CHF. Keywords: fibrinogen/albumin ratio, FAR, contrast-induced acute kidney injury, CI-AKI, congestive heart failure, CHF, biomarker, prognosis