Karasu Mehdi, Şahin Şeyda
Department of Cardiology, Fethi Sekin Sehir Hastanesi, Elazıg 23280, Turkey.
Diagnostics (Basel). 2025 Jun 27;15(13):1638. doi: 10.3390/diagnostics15131638.
: Coronary artery ectasia (CAE) is characterized by abnormal dilation of the coronary arteries and is associated with adverse cardiovascular events. Inflammation is believed to play a pivotal role in the development and progression of CAE. The neutrophil-percentage-to-albumin ratio (NPAR) has emerged as a novel marker of systemic inflammation and may serve as a useful tool in the evaluation of CAE. This study aimed to assess the association between the NPAR and CAE and compare its predictive value to established inflammatory biomarkers, including highly sensitive C-reactive protein (hsCRP), the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR). : A retrospective analysis was conducted on 5212 patients who underwent elective coronary angiography between March 2019 and March 2023. The cohort included 165 patients with isolated CAE and 180 controls with normal coronary anatomy. Inflammatory markers and their correlation with CAE were analyzed using logistic regression models and receiver operating characteristic (ROC) analysis to determine predictive performance. : The NPAR was significantly elevated in the CAE group compared to the controls ( < 0.001). Multivariate analysis identified the NPAR (OR: 2.14, = 0.003) and CRP (OR: 1.53, = 0.02) as independent predictors of CAE. ROC analysis demonstrated that the NPAR had superior predictive value over CRP (AUC: 0.725 vs. 0.635). Additionally, the NPAR showed a strong correlation with CAE severity based on the Markis classification, with higher NPAR values associated with more advanced disease. : The NPAR is an independent predictor of CAE and outperforms CRP in predicting both the presence and severity of the condition. As a cost-effective and accessible biomarker, the NPAR may enhance the clinical assessment of CAE and provide valuable insights into its inflammatory underpinnings. Further prospective studies are warranted to validate these findings and explore the potential of the NPAR in risk stratification and management of CAE patients.
冠状动脉扩张（CAE）的特征是冠状动脉异常扩张，并与不良心血管事件相关。炎症被认为在CAE的发生和发展中起关键作用。中性粒细胞与白蛋白比值（NPAR）已成为全身炎症的一种新型标志物，可能作为评估CAE的有用工具。本研究旨在评估NPAR与CAE之间的关联，并将其预测价值与已确立的炎症生物标志物进行比较，包括高敏C反应蛋白（hsCRP）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）。
对2019年3月至2023年3月期间接受选择性冠状动脉造影的5212例患者进行了回顾性分析。该队列包括165例孤立性CAE患者和180例冠状动脉解剖结构正常的对照者。使用逻辑回归模型和受试者工作特征（ROC）分析来分析炎症标志物及其与CAE的相关性，以确定预测性能。
与对照组相比，CAE组的NPAR显著升高（<0.001）。多变量分析确定NPAR（OR：2.14，=0.003）和CRP（OR：1.53，=0.02）是CAE的独立预测因子。ROC分析表明，NPAR比CRP具有更好的预测价值（AUC：0.725对0.635）。此外，根据Markis分类，NPAR与CAE严重程度密切相关，NPAR值越高，疾病越严重。
NPAR是CAE的独立预测因子，并在预测疾病的存在和严重程度方面优于CRP。作为一种具有成本效益且易于获得的生物标志物，NPAR可能会加强CAE的临床评估，并为其炎症基础提供有价值的见解。有必要进行进一步的前瞻性研究来验证这些发现，并探索NPAR在CAE患者风险分层和管理中的潜力。
