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

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 10th 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.Registration No.: PROSPERO (CRD420251229169).