Patients with type 2 diabetes mellitus (T2DM) and acute non-ST-segment elevation myocardial infarction (NSTEMI) are at high risk of adverse outcomes. The neutrophil percentage-to-albumin ratio (NPAR), integrates inflammatory and nutritional information from routine laboratory testing. We evaluated whether admission NPAR was associated with 1-year all-cause mortality in this population. This retrospective single-center study included consecutive adults with T2DM and NSTEMI admitted between April 2018 and April 2024 to The Central Hospital of Karamay. NPAR was calculated from the first laboratory tests obtained within 24 h of admission. Candidate variables were screened by least absolute shrinkage and selection operator (LASSO) regression and refit in multivariable logistic regression. Discrimination was assessed by receiver operating characteristic (ROC) curves and the area under the curve (AUC), with DeLong testing for correlated ROC curves. Internal validation used 1,000 bootstrap resamples, and restricted cubic splines were used to explore nonlinearity. During the 1-year follow-up period, 37 patients (13.4%) died. Multivariable analysis identified age, NPAR, and hemoglobin as independent predictors of one-year all-cause mortality. NPAR showed good discriminatory performance with an AUC of 0.816. A prediction model incorporating NPAR achieved an AUC of 0.839. RCS analysis demonstrated a significant nonlinear association between NPAR and mortality, with risk increasing more rapidly when NPAR exceeded approximately 1.90. Admission NPAR was independently associated with one-year all-cause mortality in patients with T2DM and NSTEMI. As an easily obtainable biomarker derived from routine laboratory tests, NPAR may serve as a useful adjunctive marker for early risk stratification in this high-risk population.
Ma et al. (Thu,) studied this question.