Related Experiment Video
Updated: Sep 17, 2025
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Neutrophil Percentage-to-Albumin Ratio as a Predictor of Collateral Circulation in Chronic Total Occlusion
İbrahim Aktaş1, Hasan Ata Bolayır1, Mehdi Karasu2
1Department of Cardiology, Faculty of Medicine, Malatya Turgut Özal University, Malatya, Türkiye.
Insights
The neutrophil percentage-to-albumin ratio (NPAR) is a key inflammatory marker linked to poor collateral circulation in chronic total occlusion (CTO) patients. This finding aids in predicting prognosis and revascularization success in coronary artery disease.
Area of Science:
- Cardiology
- Inflammation Markers
Background:
- Chronic total occlusion (CTO) represents advanced coronary artery disease (CAD).
- Collateral circulation is vital for blood supply in CTO, impacting patient outcomes.
- Neutrophil percentage-to-albumin ratio (NPAR) is an established inflammation indicator.
Purpose of the Study:
- To investigate the association between NPAR and collateral circulation in CTO patients.
- To determine if NPAR can predict collateralization quality in CAD.
Main Methods:
- Retrospective analysis of 320 CAD patients with CTO.
- Coronary angiography and Cohen-Rentrop classification for collateral assessment.
- Multivariate analysis of NPAR and other inflammatory markers.
Main Results:
- NPAR significantly correlated with poor collateral circulation.
- NPAR, WBC, NLR, and CRP independently predicted poor collateralization.
- Fasting glucose and diabetes mellitus were also linked to reduced collateral flow.
Conclusions:
- NPAR is a simple, effective marker for predicting collateral circulation quality in CTO.
- NPAR can aid in assessing prognosis and guiding percutaneous revascularization strategies.
- Further extensive research is recommended to validate these findings.
Background:
This study aimed to investigate the relationship between neutrophil percentage-to-albumin ratio (NPAR) and collateral circulation in patients with chronic total occlusion (CTO). Chronic total occlusion is an advanced stage of coronary artery disease (CAD) and is characterized by complete occlusion of the coronary arteries. Collateral circulation provides alternative routes that supply blood flow instead of occluded arteries and may affect the prognosis of CTO patients. Neutrophil percentage-to-albumin ratio is recognized as an indicator of inflammation and can be used to predict the prognosis of various diseases.
Methods:
In this retrospective study, 320 patients with CAD who were diagnosed with CTO by coronary angiography were included. Demographic characteristics, clinical findings, and laboratory test results were recorded. The degree of coronary collateral circulation was classified according to the Cohen-Rentrop method. Neutrophil percent-age-to-albumin ratio and other inflammatory parameters were measured. The relationship between NPAR and collateral circulation was evaluated using multivariate analysis.
Results:
Neutrophil percentage-to-albumin ratio levels were significantly associated with poor collateral circulation. Neutrophil percentage-to-albumin ratio, together with other inflammatory parameters (white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein), was identified as an independent marker of poor collateral circulation in CTO patients. Fasting blood glucose levels and diabetes mellitus were also associated with poor collateral circulation.
Conclusion:
Neutrophil percentage-to-albumin ratio is emerging as a simple and effective inflammatory marker that can be used to predict the quality of collateral circulation in CTO patients. This is important for predicting the prognosis of CTO patients and the success of percutaneous revascularization. However, more extensive studies are needed.
