Association between fibrinogen–albumin ratio and outcomes in myocardial infarction: A systematic review and meta-analysis

Abstract

Background & Objective: The fibrinogen–albumin ratio (FAR) is an emerging biomarker that reflects systemic inflammation and coagulation balance. Its prognostic significance in myocardial infarction (MI) remains uncertain. This systematic review and meta-analysis evaluated the association between FAR and clinical outcomes in MI patients.

Methodology: A comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted up to 10^th November 2025 for studies reporting the relationship between FAR and outcomes in MI. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models.

Results: Six studies involving 3,007 MI patients were included. Five studies examined ST-elevation MI and one assessed MI with non-obstructive coronary arteries. Pooled analysis revealed that elevated FAR significantly predicted major adverse cardiac events (MACE) (OR: 2.62; 95% CI: 1.88–3.65; I²=4%) and no-reflow phenomenon (OR: 2.01; 95% CI: 1.75–2.30; I²=88%). However, FAR was not significantly associated with mortality (OR: 1.03; 95% CI: 0.99–1.06; I²=90%).

Conclusions: Elevated FAR is linked with increased risks of MACE and no-reflow after reperfusion in MI patients, but not with mortality. FAR may be a simple, affordable marker for early prognostic evaluation, requiring further validation in large prospective studies.