ASSOCIATION BETWEEN NEUTROPHIL PERCENTAGE-TO-ALBUMIN RATIO AND CLINICAL OUTCOMES IN MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERIES PATIENTS

Erkan Kahraman, Koray Kalenderoğlu, Fatih Furkan Yücedağ, Yalçın Velibey, Göktürk İpek

Haydarpaşa Numune Medical Journal - 2025;65(4):394-401

Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital

 

Introduction: This study sought to analyze the predictive importance of neutrophil percentage/albumin ratio (NPAR) levels at hospitalization for one-year major adverse cardiovascular and cerebrovascular events (MACCE) in patients with nonobstructive myocardial infarction (MINOCA). Methods: This retrospective cohort study included 495 patients. Patients were categorized into two groups: those with MACCE and those without. The neutrophil percentage-to-albumin ratio (NPAR), C-reactive protein (CRP)/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation (SII) index, and advanced lung cancer inflammation index (ALI) were calculated for all patients, and the correlations of these inflammation-based biomarkers with 1-year MACCE were assessed. Results: CRP, neutrophil count, neutrophil percentage, NLR, SII, CAR, and NPAR were significantly higher in MACCE (+) patients (p<0.001). In contrast, body mass index (BMI), lymphocyte count, albumin, and ALI values were markedly lower in the MACCE (+) group (p<0.001). In receiver operating characteristic (ROC) curve analysis, NPAR had a greater area under the curve (AUC: 0.970) value than either ALI (AUC: 0.932), SII (AUC: 0.927), or CAR (AUC: 0.928). Discussion and Conclusion: Inflammatory biomarkers NPAR, CAR, SII, and ALI can predict one-year major adverse cardiovascular and cerebrovascular events for patients with MINOCA. NPAR shows better predictive value compared to other biomarkers.