Elevated neutrophil percentage-to-albumin ratio (NPAR) independently predicted early recurrence of atrial fibrillation after radiofrequency catheter ablation with an HR of 1.173.
Cohort (n=394)
No
Does elevated preprocedural neutrophil percentage-to-albumin ratio (NPAR) predict early recurrence of atrial fibrillation in patients undergoing radiofrequency catheter ablation?
The preprocedural neutrophil percentage-to-albumin ratio (NPAR) is a novel, independent predictor of early atrial fibrillation recurrence following radiofrequency catheter ablation.
Effect estimate: HR 1.173 (95% CI 1.104-1.247)
p-value: p=<0.001
Purpose: The neutrophil percentage-to-albumin ratio (NPAR) serves as a robust prognostic indicator for adverse cardiovascular events. This pioneering study is the first to examine the relationship between the NPAR and post-ablation atrial fibrillation (AF) recurrence in patients undergoing radiofrequency catheter ablation (RFCA). Patients and Methods: In this retrospective analysis, 394 treatment-naïve AF patients undergoing initial RFCA were enrolled and stratified into recurrence and non-recurrence cohorts. The study utilized four composite inflammatory indices as biomarkers: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and NPAR. Cox proportional hazards regression modeling was employed to assess the prognostic significance of post-ablation AF recurrence following RFCA. Receiver operating characteristic (ROC) curve analysis evaluated the discriminative capacity of inflammatory biomarkers, utilizing area under the curve (AUC) quantification as the principal measure for prognostic stratification accuracy. Results: With a median follow-up duration of 12.00 months, early AF recurrence occurred in 88 cases (22.34%), demonstrating significantly higher incidence rates in patients with elevated NPAR levels. Univariate Cox regression identified significant associations between AF recurrence and inflammatory indices (NLR, PLR, SII, NPAR), persistent AF phenotype, heart failure status, age, serum creatinine levels, left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP) levels, and left atrial diameter (LAD) (all P < 0.05). Multivariable analysis demonstrated NPAR, persistent AF, and LAD as independent predictors of post-ablation recurrence (adjusted P < 0.05). ROC curve analysis demonstrated superior predictive performance of the NPAR for AF recurrence compared to SII, PLR, and NLR, with AUC of 0.706 (P < 0.01; 95% CI: 0.642-0.770). Kaplan-Meier survival analysis demonstrated significantly increased 1-year AF recurrence rates among patients with elevated NPAR levels exceeding 15.36 (log-rank P < 0.01). Conclusion: The NPAR represents a promising novel biomarker for risk stratification of post-ablation AF recurrence in patients undergoing RFCA.
Nie et al. (Sat,) conducted a cohort in Atrial Fibrillation (n=394). Neutrophil Percentage-to-Albumin Ratio (NPAR) vs. Lower NPAR was evaluated on Early recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (HR 1.173, 95% CI 1.104-1.247, p=<0.001). Elevated neutrophil percentage-to-albumin ratio (NPAR) independently predicted early recurrence of atrial fibrillation after radiofrequency catheter ablation with an HR of 1.173.