Background  The prevalence of cardiovascular diseases is increasing year by year in China, and the standardized mortality of coronary heart disease is still on the rise. Therefore, timely and accurate assessment of the severity of coronary artery lesions is of great significance to reduce the mortality of coronary heart disease and improve the prognosis of patients with coronary heart disease.

  Objective  To investigate the correlation between fibrinogen/albumin ratio (FAR) and the severity of coronary artery disease and its clinical application value.

  Methods  A total of 849 patients who underwent coronary angiography in the Department of Cardiology, Zhongda Hospital of Southeast University from January to December in 2019 were enrolled. Among them, 724 patients were diagnosed with coronary heart disease and 125 patients were completely normal. The coronary heart disease group was divided into mild stenosis group (n=242), moderate stenosis group (n=233) and severe stenosis group(n=249) to investigate the relationship between FAR and the severity of coronary artery disease. Binary logistic regression analysis was applied to analyze the independent risk factors for coronary heart disease. Disordered multi-class logistic regression analysis was used to analyze the influencing factors of different coronary stenosis degrees. The receiver operating curve (ROC) was used to determine the diagnostic value of FAR for moderate to severe coronary lesions.

  Results  Binary Logistic regression showed that after adjusting for other related factors, FAR was an independent risk factor for coronary heart disease (OR=1.504, 95% CI: 1.266-1.786, P<0.05). Disordered multi-class logistic regression analysis found that compared with the mild stenosis group, after adjusting for other related factors, FAR was still an independent risk factor for Gensini scores in the moderate stenosis group (OR=1.499, 95% CI: 1.316-1.708, P＜0.05). Comparing the severe stenosis group with the mild stenosis group, after adjusting for other risk factors, FAR was still an independent risk factor for Gensini scores (OR=2.019, 95% CI: 1.756-2.321, P<0.05). When the cut-off value of FAR was 9.62%, the area under the curve (AUC) for the diagnosis of moderate and severe coronary artery lesions in patients with coronary heart disease was 0.737 (95% CI: 0.703-0.769), with the sensitivity of 63.7% and the specificity of 72.7%.

  Conclusion  FAR is closely related to the severity of coronary artery disease in patients with coronary heart disease, which is an independent risk factor of coronary artery disease and has a certain value in the evaluation of the severity of coronary artery disease.