Fibrinogen-to-albumin ratio and risk of thrombotic diseases incidence.

BACKGROUND: The fibrinogen-to-albumin ratio (FAR) is linked to cardiovascular diseases, but its association with thrombotic diseases in the general population remains unclear. OBJECTIVE: To investigate the relationship between FAR and thrombotic diseases and assess their dose-response association. METHODS: This prospective cohort study included 18,208 participants (mean age 53.2 years, 41.9% female) from the Xifei community cohort (2011–2021). Participants were categorized into FAR quintiles (Q1–Q5). Restricted cubic spline and Cox regression models were used to assess the associations between FAR and thrombotic risk. RESULTS: Over follow-up of 8 years, 1,373 thrombotic events occurred. Compared to the group of lowest FAR, the group of highest FAR showed significantly increased risks of combined arterial and venous thrombosis (HR = 1.36, 95% CI 1.08–1.70), arterial thrombosis (HR = 1.35, 1.07–1.70), and stroke (HR = 1.36, 1.06–1.76). Risks for acute myocardial infarction, venous thromboembolism, deep venous thrombosis, and pulmonary embolism were not statistically significant. A nonlinear dose-response relationship between FAR and thrombotic risk was observed. CONCLUSIONS AND RELEVANCE: Higher baseline FAR was associated with an elevated risk of arterial and venous thrombosis, arterial thrombosis, and stroke, whereas associations with acute myocardial infarction and venous outcomes (VTE, DVT, and PE) were not statistically significant. These findings suggest that FAR may be a useful biomarker for thrombotic risk assessment in the general population.