Association Between Neutrophil Percentage-to-Albumin Ratio and 2-Year Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement
Anatolian Journal of Cardiology, cilt.30, sa.4, ss.225-234, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.14744/anatoljcardiol.2025.5749
- Dergi Adı: Anatolian Journal of Cardiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.225-234
- Anahtar Kelimeler: Inflammation, mortality, neutrophils, prognostic value, serum albumin, transcatheter aortic valve replacement
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Transcatheter aortic valve replacement (TAVR) is the standard therapy for severe aortic stenosis, particularly in elderly patients with comorbidities. Simple biomarkers to predict mid-term mortality are still needed. This study evaluated the prognostic value of the preprocedural neutrophil percentage-to-albumin ratio (NPAR) for 2-year all-cause mortality after TAVR. Methods: A total of 618 patients undergoing TAVR between 2013 and 2023 were retrospectively analyzed. NPAR was calculated as neutrophil percentage × 100 / albumin (g/dL), and patients were classified into tertiles. The prognostic role of NPAR was assessed using Cox regression, Kaplan-Meier survival analysis, and receiver operating characteristic curves. Results: Baseline characteristics were similar across tertiles, but higher NPAR was associated with elevated inflammation and lower albumin levels. In multivariable Cox analysis, high NPAR independently predicted 2-year mortality (T3 vs. T1: hazard ratio [HR] 2.75, 95% CI 1.77-4.28; P < .001). In a model including both categorical NPAR and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), tertile 3 of NPAR (HR 2.49, 95% CI 1.61-3.85; P < .001) and STS-PROM (HR 1.31, 95% CI 1.12-1.53; P = .001) remained independent predictors, indicating incremental prognostic value of NPAR beyond established surgical risk scores. Kaplan-Meier curves showed the lowest survival in the highest tertile (35.9% mortality at 2 years). Receiver operating characteristic analysis confirmed NPAR had the best discriminatory ability (area under the curve = 0.703). Conclusion: Preprocedural NPAR is an independent, low-cost, and readily available biomarker for predicting mid-term mortality after TAVR. Its integration into risk models may improve prediction accuracy and help guide patient management.