The Relationship Between the Neutrophil Percentage-to-Albumin Ratio and Rates of 28-Day Mortality in Atrial Fibrillation Patients 80 Years of Age or Older

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia among the older patients (≥ 80 years) in clinical practice. The index of neutrophil percentage-to-albumin ratio (NPAR) is a reliable predictor of adverse outcomes in cardiovascular diseases. There is scarce evidence regarding the association between NPAR and mortality among the older patients with AF. Methods: The research was conducted among 1141 patients with AF between January 2015 and June 2020, hospitalized at Huadong Hospital affiliated with Fudan University. The primary outcome were 28-day all-cause and cardiovascular mortality. Cox regression analysis and Kaplan-Meier survival curves were used to explore the correlation between NPAR and 28-day all-cause or cardiovascular mortality. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) were performed for the predictive values of NPAR on prognosis. Results: The 28-day death rate from cardiovascular disease and all-causes were 3.3% and 8.7%, respectively. Continuous NPAR levels were positively associated with all-cause (HR 1.13, 95% CI 1.09, 1.16) and cardiovascular (HR 1.16, 95% CI 1.10, 1.23) mortality after adjustment for confounding variables. Relative to patients in the T1 group, those in higher NPAR tertiles also exhibit elevated risks of all-cause (P < 0.001) and cardiovascular mortality (P < 0.001). Furthermore, both all-cause and cardiovascular mortality rates rose with increasing NPAR in all analyzed subgroups. Conclusion: NPAR values are consistently positively related to 28-day all-cause and cardiovascular mortality rates in patients ≥80 years of age with AF.

Associations of neutrophil-percentage-to-albumin ratio level with all-cause mortality and cardiovascular disease-cause mortality among patients with hypertension: evidence from NHANES 1999–2010

“…Notably, NPAR exhibited superior predictive accuracy for 5-year all-cause mortality compared to other hematologic inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-lymphocyte ratio (ELR), and similar markers. In the study by Jiasheng Cai et al ( 17 ) involving 1,141 patients aged 80 years and older diagnosed with atrial fibrillation (AF), the level of NPAR exhibited a significant association with 28-day all-cause mortality after adjusting for confounding variables. In patients undergoing peritoneal dialysis (PD), Youqun Gao et al's ( 18 ) study revealed that individuals with elevated NPAR are associated with a higher risk of mortality.…”

The role of neutrophil percentage to albumin ratio in predicting 1-year mortality in elderly patients with hip fracture and external validation

“…Changes in NPAR better reflect the dynamic balance of immunity and inflammation and disease activity, making it an ideal biological indicator. Recent studies have shown that elevated NPAR levels are strongly associated with poor prognosis in patients with cardiovascular disease ( 35 ). In patients with acute myocardial infarction, higher NPAR values were related to short-term mortality ( 36 ).…”