Abstract
Background Neutrophil percentage-to-albumin ratio (NPAR) has been proved to be associated with clinical outcome of many diseases. This study was aimed at exploring the independent effect of NPAR on all-cause mortality of critically ill patients with coronary artery disease (CAD). Method NPAR was calculated as neutrophil percentage numerator divided by serum albumin concentration. Clinical endpoints were 30-day, 90-day, and 365-day all-cause mortality. Multivariable Cox proportional hazard models were performed to confirm the association between NPAR and all-cause mortality. Result 3106 patients with CAD were enrolled. All-cause mortality rates of 30 days (P < 0.001), 90 days (P < 0.001), and 365 days (P < 0.001) increased as NPAR tertiles increased. And after adjusting for possible confounding variables, NPAR was still independently associated with 30-day (third tertile group versus first tertile group: HR, 95% CI: 1.924, 1.471-2.516; P for trend < 0.001), 90-day (third tertile group versus first tertile group: HR, 95% CI: 2.053, 1.646-2.560; P for trend < 0.001), and 365-day (third tertile group versus first tertile group: HR, 95% CI: 2.063, 1.717-2.480; P for trend < 0.001) all-cause mortality in patients with CAD. Subgroup analysis did not find obvious interaction in most subgroups. Conclusion NPAR was independently correlated with 30-day, 60-day, and 365-day all-cause mortality in critically ill patients with CAD.
Highlights
Tremendous advances have been made in clinical and basic cardiovascular research over the past few decades, coronary artery disease (CAD) still remains the major cause of death all over the world [1, 2]; readily accessible and inexpensive prognostic predictors are still necessary for patients with CAD, especially for critically ill patients
The selected population must meet the following requirements: (1) adult patients who were diagnosed with coronary atherosclerosis or myocardial infarction according to ICD-9 diagnosis code and (2) parameters of neutrophil percent and serum albumin concentration were available after admission to intensive care unit (ICU)
Neutrophil percentage-to-albumin ratio (NPAR) was still independently associated with 30-day, 90-day
Summary
Tremendous advances have been made in clinical and basic cardiovascular research over the past few decades, CAD still remains the major cause of death all over the world [1, 2]; readily accessible and inexpensive prognostic predictors are still necessary for patients with CAD, especially for critically ill patients.Inflammation was proved to be related to atherosclerosis closely and played a key role in coronary plaque progression and adverse events after stent implantation [3–5]. Lower serum albumin concentration was proved to have a close connection to bad clinical outcomes in patients with CAD mainly due to malnutrition and inflammation [7, 8]. This study was aimed at exploring the independent effect of NPAR on all-cause mortality of critically ill patients with coronary artery disease (CAD). After adjusting for possible confounding variables, NPAR was still independently associated with 30-day (third tertile group versus first tertile group: HR, 95% CI: 1.924, 1.471-2.516; P for trend < 0.001), 90-day (third tertile group versus first tertile group: HR, 95% CI: 2.053, 1.646-2.560; P for trend < 0.001), and 365-day (third tertile group versus first tertile group: HR, 95% CI: 2.063, 1.717-2.480; P for trend < 0.001) all-cause mortality in patients with CAD. NPAR was independently correlated with 30-day, 60-day, and 365-day all-cause mortality in critically ill patients with CAD
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