The Relationship Between the Fibrinogen-to-Albumin Ratio and Short-Term Mortality in Chinese Patients With Chronic Heart Failure: A Retrospective Cohort Analysis.

Background: Recent studies have identified an association between the fibrinogen-to-albumin ratio (FAR) and the prognosis of coronary heart disease; however, evidence regarding its significance in heart failure patients remains limited. This study aims to examine the relationship between the FAR and short-term mortality among individuals with heart failure. Methods: In this retrospective cohort study, we conducted an analysis of clinical data from patients with heart failure who were hospitalized at Zigong Fourth People's Hospital from December 2016 to June 2019. The primary exposure variable was the FAR, while the outcomes of interest were mortality rates at 28 days and 3 months. Multivariate logistic regression evaluated FAR's independent association with short-term mortality, with predictive accuracy assessed via ROC curves and subgroup consistency through stratified analyses. Furthermore, smooth curve fitting was utilized to investigate the linear relationship, and a series of sensitivity analyses were conducted to validate the robustness of the findings. Results: The analysis included 1880 participants, of whom 58.1% were females and 54.1% were aged 60-80 years. Our study showed that a one standard deviation rise in the FAR was linked to a 45% increase in 28-day mortality (OR = 1.45, 95% CI = 1.02-2.06, p=0.04) after adjusting for potential confounding factors. The 28-day mortality rate was markedly elevated in the high FAR group (FAR > 0.126) compared to the low FAR group (OR = 4.01, 95% CI = 1.17-13.82, p=0.028). Comparable findings were noted at the 3-month mark. There were no significant interactions found in the subgroup analysis. A linear association was identified between FAR and short-term mortality. The optimal FAR cutoff value for predicting 28-day mortality was 0.156 (sensitivity 68.0%, specificity 59.4%, AUC = 0.654), while for 3-month mortality, it was 0.156 (sensitivity 68.0%, specificity 58.3%, AUC = 0.647). Sensitivity analyses corroborated the robustness of our findings. Conclusion: A positive correlation exists between the FAR and short-term mortality among Chinese patients with heart failure. These findings underscore the necessity for further investigation into the underlying pathophysiological mechanisms and potential therapeutic interventions associated with FAR in the context of heart failure.