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已发表论文
中性粒细胞百分比与白蛋白比值对射频导管消融术后早期房颤复发的预测价值
Authors Nie L, Nie Q, Liu K, Zhang S, Wang Y, Yu Y, Feng W, Chen Y
Received 12 August 2025
Accepted for publication 27 October 2025
Published 8 November 2025 Volume 2025:18 Pages 15615—15626
DOI https://doi.org/10.2147/JIR.S557322
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Qing Lin
Lujing Nie,1 Qingmei Nie,2 Kesen Liu,1 Shujie Zhang,1 Yujie Wang,3 Yaxuan Yu,1 Wenjiu Feng,1 Yanbo Chen1
1Department of Arrhythmia, Weifang People’s Hospital, Shandong Second Medical University, Weifang, Shandong, 261000, People’s Republic of China; 2Department of Emergency Intensive Care Unit, Weifang People’s Hospital, Weifang, Shandong, 261000, People’s Republic of China; 3Department of Cardiology, Changle People’s Hospital, Weifang, Shandong, 261000, People’s Republic of China
Correspondence: Yanbo Chen, Email cyb20221206@163.com
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.
Keywords: neutrophil percentage-to-albumin ratio, atrial fibrillation, radiofrequency catheter ablation, recurrence
1Department of Arrhythmia, Weifang People’s Hospital, Shandong Second Medical University, Weifang, Shandong, 261000, People’s Republic of China; 2Department of Emergency Intensive Care Unit, Weifang People’s Hospital, Weifang, Shandong, 261000, People’s Republic of China; 3Department of Cardiology, Changle People’s Hospital, Weifang, Shandong, 261000, People’s Republic of China
Correspondence: Yanbo Chen, Email cyb20221206@163.com
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.
Keywords: neutrophil percentage-to-albumin ratio, atrial fibrillation, radiofrequency catheter ablation, recurrence