Association Between Neutrophil Percentage-to-Albumin Ratio and Clinical Outcomes in Myocardial Infarction with Non-obstructive Coronary Arteries Patients

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 non-obstructive 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.

Keywords: Adverse outcome, inflammatory biomarkers, MINOCA, neutrophil percentage-to-albumin ratio