Prognostic value of the neutrophil percentage-to-albumin ratio for all-cause and cardiovascular disease mortality in individuals with coronary heart disease: A cohort study

The association between the neutrophil percentage-to-albumin ratio (NPAR) and all-cause and cardiovascular disease mortality in individuals with coronary heart disease (CHD) remains unclear. This study aimed to investigate the correlation between NPAR levels and the risks of all-cause and cardiovascular disease mortality within this specific patient population. This research included 935 participants diagnosed with CHD. We conducted survival analyses using the Kaplan-Meier method and employed multivariate Cox proportional hazards regression models to assess the association between NPAR, categorized into tertiles, and the risk of all-cause and cardiovascular mortality. Additionally, we utilized restricted cubic splines to analyze potential nonlinear relationships and performed subgroup analyses based on relevant covariates to identify populations potentially at higher risk. Over the follow-up period, 260 all-cause deaths and 100 cardiovascular deaths were recorded among the participants. Multivariate Cox regression analysis demonstrated that, compared to the lowest NPAR tertile (Q1), participants in the highest tertile (Q3) had significantly elevated risks of all-cause mortality (hazard ratio = 1.76, 95% confidence interval: 1.19-2.61, P = .005) and cardiovascular mortality (hazard ratio = 3.12, 95% confidence interval: 1.67-5.81, P < .001). The restricted cubic splines analysis confirmed a nonlinear association between continuous NPAR levels and both all-cause and cardiovascular mortality. Higher NPAR levels were significantly associated with an increased likelihood of both all-cause and cardiovascular mortality among patients with CHD. These findings suggest that NPAR could serve as a potentially valuable prognostic marker for predicting mortality risk in individuals affected by CHD.