Cetinkaya Zeki, Yilmaz Yucel, Baran Oguzhan, Secen Ozlem, Gelen Mehmet Ali, Sahin Seyda, Yavcin Ozkan, Ekmekyapar Muhammed, Yıldırım Erkan, Kelesoglu Saban
Department of Cardiology, Elazıg Fethi Sekin City Hospital, 23280 Elazıg, Türkiye.
Department of Cardiology, Kayseri City Training and Research Hospital, University of Health Sciences, 38280 Kayseri, Türkiye.
Medicina (Kaunas). 2025 Apr 23;61(5):779. doi: 10.3390/medicina61050779.
The neutrophil-percentage-to-albumin ratio (NPAR) has been recognized as an independent risk factor for cardiovascular diseases. In our study, we investigated whether the NPAR is associated with the formation of coronary collateral circulation (CCC) in patients with chronic coronary syndrome (CCS). A total of 681 patients with CCS were included in this study. Of these patients, 571 had chronic total occlusion in at least one major vessel and developed collateral vessels. In total, 110 patients were in the control group, who had CCS but did not have complete occlusion in a major vessel and did not develop collateral vessels. Patients with collateral vessels on coronary angiography were divided into two groups according to the Rentrop score: poor CCC (Rentrop 0-1) and good CCC (Rentrop 2-3). Blood samples were taken for the NPAR and other biochemical parameters in all patients during hospitalization. The NPAR was calculated as the neutrophil-percentage-to-albumin ratio. The group of patients with poor CCC had a higher white blood count (WBC), neutrophil, C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and NPAR values than patients with good CCC ( < 0.001, for all). Multivariate logistic regression analysis showed that high NPAR levels were an independent predictor of poor CCC (OR: 2.79, 95% CI:1.7-4.6, < 0.001), accompanied by neutrophil, CRP, CAR, and NLR levels. In the receiver operator characteristic curve (ROC analysis), the cut-off value for the NPAR to indicate poor CCC was 1.78 with a sensitivity of 76.6% and specificity of 81.4% (area under ROC curve = 0.804 95% CI (0.753-0.854), < 0.001). We demonstrated that the NPAR may be an independent predictor of poor CCC development in clinical practice.
中性粒细胞与白蛋白比值（NPAR）已被公认为心血管疾病的独立危险因素。在我们的研究中，我们调查了NPAR是否与慢性冠状动脉综合征（CCS）患者的冠状动脉侧支循环（CCC）形成有关。本研究共纳入681例CCS患者。其中，571例患者至少有一支主要血管发生慢性完全闭塞并形成了侧支血管。共有110例患者作为对照组，他们患有CCS，但主要血管未发生完全闭塞且未形成侧支血管。根据Rentrop评分，冠状动脉造影显示有侧支血管的患者被分为两组：CCC不良组（Rentrop 0 - 1）和CCC良好组（Rentrop 2 - 3）。所有患者在住院期间采集血样检测NPAR及其他生化参数。NPAR计算为中性粒细胞百分比与白蛋白的比值。CCC不良组患者的白细胞计数（WBC）、中性粒细胞、C反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）、CRP与白蛋白比值（CAR）及NPAR值均高于CCC良好组患者（所有P均<0.001）。多因素logistic回归分析显示，高NPAR水平是CCC不良的独立预测因素（OR：2.79，95%CI：1.7 - 4.6，P<0.001），同时伴有中性粒细胞、CRP、CAR及NLR水平升高。在受试者工作特征曲线（ROC分析）中，NPAR提示CCC不良的截断值为1.78，灵敏度为76.6%，特异度为81.4%（ROC曲线下面积 = 0.804，95%CI（0.753 - 0.854），P<0.001）。我们证明，在临床实践中，NPAR可能是CCC不良发展的独立预测因素。
