Karaca Mehmet, Gumusdag Ayca
Cardiology Department, Atasehir Memorial Hospital, Uskudar University, Istanbul 34758, Turkey.
Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, University of Health Sciences Turkey, Istanbul 34668, Turkey.
Medicina (Kaunas). 2024 Dec 22;60(12):2101. doi: 10.3390/medicina60122101.
: This study aimed to investigate whether neutrophil percentage-to-albumin ratio (NPAR) levels on admission have prognostic significance regarding one-year major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST-elevation myocardial infarction (NSTEMI) patients. : A total of 464 patients aged 59.2 ± 11.6 years constituted the cohort of this retrospectively designed study. Considering a 1-year follow-up period, the patients were divided into two groups: those with MACCEs and those without. The complete blood count, serum C-reactive protein and serum albumin levels were measured at admission. The NPAR, C-reactive protein/albumin ratio (CAR) and systemic immune-inflammation (SII) index were calculated for all patients, and the associations of these inflammatory-based biomarkers with 1-year MACCEs were evaluated. : During the 12-month follow-up period, MACCEs were observed in 75 (16.2%) patients, of which 35 (7.5%) patients died. The patients with MACCEs had higher CRP ( < 0.001), a higher percentage of neutrophils ( < 0.001), lower albumin levels ( < 0.001), a higher CAR ( < 0.001), a higher SII index ( = 0.008) and a higher NPAR ( < 0.001). A high anatomical SxSI score, a high low-density lipoprotein cholesterol level, hypoalbuminemia, high neutrophil counts, a high NPAR level and a high CAR level were independent predictors for one-year MACCEs (all < 0.05). The NPAR (area under the curve [AUC] = 0.775, < 0.001) and albumin level (AUC = 0.708, < 0.001) had better and sufficient discriminatory power and predictive accuracy in determining one-year MACCEs, when compared to the neutrophil (AUC = 0.693, < 0.001), CAR (AUC = 0.639, < 0.001) and SII index (AUC = 0.660, < 0.001), in terms of the receiver operating characteristic curve. The DeLong test revealed that the predictive performance of the NPAR was superior to that of the other inflammatory parameters. In particular, individuals with an NPAR value greater than 17.6 were at greater risk of developing MACCEs ( < 0.001). : The NPAR can be used as a newly identified promising inflammatory biomarker to predict one-year MACCEs in NSTEMI patients undergoing revascularization therapy.
本研究旨在探讨非ST段抬高型心肌梗死（NSTEMI）患者入院时的中性粒细胞百分比与白蛋白比值（NPAR）水平对1年主要心血管和脑血管不良事件（MACCE）是否具有预后意义。本项回顾性设计研究的队列共纳入464例年龄为59.2±11.6岁的患者。考虑到1年的随访期，将患者分为两组：发生MACCE的患者和未发生MACCE的患者。入院时检测全血细胞计数、血清C反应蛋白和血清白蛋白水平。计算所有患者的NPAR、C反应蛋白/白蛋白比值（CAR）和全身免疫炎症（SII）指数，并评估这些基于炎症的生物标志物与1年MACCE的相关性。在12个月的随访期内，75例（16.2%）患者发生MACCE，其中35例（7.5%）患者死亡。发生MACCE的患者CRP水平更高（<0.001）、中性粒细胞百分比更高（<0.001）以及白蛋白水平更低（<0.001），CAR更高（<0.001）、SII指数更高（=0.008）和NPAR更高（<0.001）。高解剖学SxSI评分、高低密度脂蛋白胆固醇水平、低白蛋白血症、高中性粒细胞计数、高NPAR水平和高CAR水平是1年MACCE的独立预测因素（均<0.05）。与中性粒细胞（曲线下面积[AUC]=0.693，<0.001）、CAR（AUC=0.639，<0.001）和SII指数（AUC=0.660，<0.001）相比，NPAR（AUC=0.775，<0.001）和白蛋白水平（AUC=0.708，<0.001）在确定1年MACCE方面具有更好且足够的鉴别能力和预测准确性，根据受试者工作特征曲线。DeLong检验显示NPAR的预测性能优于其他炎症参数。特别是，NPAR值大于17.6的个体发生MACCE的风险更高（<0.001）。NPAR可作为一种新发现的有前景的炎症生物标志物，用于预测接受血运重建治疗的NSTEMI患者的1年MACCE。
