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Neutrophil-to-albumin ratio: a promising tool for CAD assessment in non-ST elevation AMI
M Karasu1, Y Karaca, E Yıldırım
1Department of Cardiology, Fethi Sekin City Hospital, Elazıg, Turkey. mehdikarasu@yahoo.com.
Insights
The Neutrophil-to-Albumin Ratio (NAR) shows promise as a biomarker for assessing coronary artery disease (CAD) severity in acute myocardial infarction (AMI) patients. NAR demonstrated superior predictive capability compared to other inflammatory markers.
Area of Science:
- Cardiovascular Medicine
- Inflammatory Biomarkers
- Acute Myocardial Infarction Research
Background:
- Inflammation is a key factor in the pathogenesis of coronary artery disease (CAD).
- Accurate assessment of CAD severity is crucial for effective patient management.
- Novel biomarkers are needed to improve risk stratification in acute myocardial infarction (AMI).
Purpose of the Study:
- To investigate the Neutrophil-to-Albumin Ratio (NAR) as a novel biomarker for CAD severity and extension.
- To evaluate NAR's predictive capability in patients with non-ST elevation acute myocardial infarction (NSTEMI).
- To compare NAR's performance against established inflammatory markers like CRPALB and SII.
Main Methods:
- Retrospective analysis of 211 consecutive patients diagnosed with non-ST elevation AMI.
- Correlation analysis between Neutrophil-to-Albumin Ratio (NAR) and Syntax Scores (SS) for CAD severity.
- Comparison of NAR with CRPALB, SII, and NPAR using Receiver Operating Characteristic (ROC) curve analysis.
Main Results:
- A significant positive correlation was found between NAR and Syntax Scores (r = .416, p < 0.01).
- Patients with intermediate-high Syntax Scores showed significantly higher NAR values compared to the low SS group.
- NAR demonstrated superior discriminatory power for CAD severity compared to CRPALB, SII, and NPAR (AUC: 0.736 vs. 0.673, 0.660, 0.717 respectively).
Conclusions:
- The Neutrophil-to-Albumin Ratio (NAR) is a potential robust predictor of CAD severity and extension in NSTEMI patients.
- NAR offers enhanced risk assessment capabilities, outperforming existing inflammatory markers.
- NAR represents a valuable addition to the clinical toolkit for managing patients with non-ST elevation AMI.
Objective:
In the context of coronary artery disease (CAD) pathogenesis, inflammation has emerged as a critical player. This study investigates the potential of the Neutrophil-to-Albumin Ratio (NAR) as a novel biomarker for assessing CAD severity and extension in patients suffering from acute myocardial infarction (AMI) without ST-segment elevation.
Patients And Methods:
We conducted a comprehensive analysis of consecutive patient records (n = 211) from a single center, focusing on individuals diagnosed with non-ST elevation AMI. To gauge CAD severity, we employed Syntax Scores (SS) and examined their correlation with NAR, C-reactive protein-albumin ratio (CRPALB), and the systemic immune inflammation index (SII). Statistical analyses were conducted to establish associations and predictive capabilities.
Results:
Our analysis revealed a significant correlation between NAR and Syntax Scores (r: .416, p<0.01). Notably, patients with intermediate-high SS exhibited significantly elevated NAR values compared to those in the low SS group [20.86+5.38 vs. 16.41+6.30 (p<0.001)]. Furthermore, NAR outperformed CRPALB, SII, and Neutrophil Percent-to-Albumin Ratio (NPAR) in discriminating CAD severity, as demonstrated by the Receiver Operating Characteristic (ROC) curve analysis (NAR AUC: 0.736; CRPALB AUC: 0.673; SII AUC: 0.660; NPAR AUC: 0.717).
Conclusions:
This study underscores the potential of NAR as a robust predictor of CAD severity and extension in non-ST elevation AMI patients. While previous markers, such as CRPALB and SII, are advantageous, NAR's superior predictive capabilities are a valuable addition to the clinician's toolkit, offering enhanced risk assessment for this specific patient subgroup.
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