Introduction and Objective: The neutrophil percentage-to-albumin ratio (NPAR) is a novel inflammatory marker linked to adverse cardiovascular outcomes. Its prognostic value in patients with lower extremity arteriosclerosis obliterans (LEASO) undergoing endovascular revascularization remains unclear. This study aimed to investigate the association between preprocedural NPAR and 1-year major adverse cardiovascular events (MACEs).Methods: A prospective cohort study was conducted in 581 LEASO patients undergoing endovascular revascularization. Preprocedural NPAR and clinical data were collected. Patients were followed for a median of 13.87 months to assess MACEs (all-cause death, acute myocardial infarction, acute stroke). Multivariable Cox regression was used to analyze the association. Restricted cubic splines (RCS) explored non-linearity. Kaplan-Meier curves and ROC analysis evaluated predictive value.Results: Within 1 year, 108 patients (18.59%) experienced MACEs. Higher preprocedural NPAR was independently associated with increased MACE risk (adjusted HR per unit: 1.083, 95% CI: 1.037-1.131, P<0.001). A significant dose-response relationship existed across NPAR quartiles (P-trend<0.01); the highest quartile had a 4.08-fold higher risk compared with the lowest (HR: 4.082, 95% CI: 1.858-8.967, P<0.001). RCS indicated a linear association (non-linearity P=0.289). Kaplan-Meier analysis confirmed significantly higher MACE incidence in the highest quartile (log-rank P<0.001). The optimal NPAR cutoff for predicting MACEs was 20.46 (AUC: 0.722, 95% CI: 0.658-0.788).Conclusion: Elevated preprocedural NPAR is an independent predictor of 1-year MACEs in LEASO patients undergoing endovascular revascularization. NPAR is a valuable, readily accessible biomarker for risk stratification in such patients.
Q. Zhao: None.
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