基于倾向性评分匹配分析入院NPAR对扩张型心肌病致心力衰竭患者预后不良的预测价值OA

Objective To analyze the predictive value of the admission neutrophil-percentage-to-albumin ratio(NPAR)for poor prognosis in patients with heart failure(HF)due to dilated cardiomyopathy(DCM)based on propensity score matching(PSM).Methods A total of 220 patients with HF due to DCM admitted from January 2022 to June 2024 were retrospectively selected.Relevant clinical data were collected upon admission.Neutrophil percentage was measured using an automated hematology analyzer,and albumin levels were determined using the bromocresol green method,with NPAR calculated as their ratio.During the one-year follow-up,poor prognosis was defined as the occurrence of rehospital-ization for HF,malignant arrhythmia,cardiac death,or all-cause death.A 1:1 PSM was applied to patients with different prognoses to obtain a sample with balanced intergroup variables.Multivariate Logistic regression analysis was used to iden-tify independent risk factors for poor prognosis in patients with HF due to DCM.The predictive values of N-terminal pro-B-type natriuretic peptide(NT-proBNP)and NPAR for poor prognosis were assessed using receiver operating characteristic(ROC)curve.Results Among 220 patients,82 patients experienced poor prognosis,with an incidence of 37.3%.Af-ter PSM,78 matched pairs of patients with balanced baseline characteristics were obtained.Following PSM,patients with poor prognosis showed significantly lower left ventricular ejection fraction and albumin levels,and significantly higher neu-trophil percentage,NT-proBNP,troponin I,C-reactive protein,and NPAR than patients with good prognosis(all P<0.05).Multivariate Logistic regression analysis revealed that elevated NT-proBNP and elevated NPAR were independent risk factors for poor prognosis in patients with HF due to DCM(all P<0.05).ROC curve analysis demonstrated that the ar-ea under the curve(AUC)of NPAR in predicting poor prognosis was 0.781,which was higher than the AUCs of neutrophil percentage(0.699)and albumin(0.716)alone(both P<0.05).The combined prediction of NT-proBNP and NPAR achieved an AUC of 0.850,which was higher than the AUCs of NT-proBNP(0.746)or NPAR(0.781)alone(both P<0.05).Conclusions Elevated admission NPAR is an independent risk factor for poor prognosis in patients with HF due to DCM and holds predictive value for patient prognosis.Furthermore,combining NPAR with NT-proBNP further enhanc-es the predictive value for poor prognosis in these patients.