ArticleBMC public health2025
Neutrophil percentage-to-albumin ratio and the risk of all-cause and cardiovascular mortality: a 20-year follow-up cohort study of 36,428 US adults.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Benchmarking inflammation-nutrition and TyG-related indices for 5-year mortality risk in adults with questionnaire-defined obstructive sleep apnea: a survey-weighted NHANES derivation cohort with multicenter external validation.Journal of translational medicine · 2026Article
- Impact of sex on the association between neutrophil percentage-to-albumin ratio and mortality in perioperative patients with chronic kidney disease: a retrospective analysis of the INSPIRE database.Perioperative medicine (London, England) · 2026Article
- Association Between Neutrophil Percentage-Albumin Ratio and Biological Aging in Rheumatoid Arthritis in the United States: A Cross-Sectional Study of NHANES.Mediators of inflammation · 2026Article
- The association between hematological inflammatory markers and atrial fibrillation recurrence after radiofrequency ablation.Frontiers in medicine · 2026Article
- Neutrophil percentage-to-albumin ratio is an independent risk factor for MACEs in patients with acute coronary syndrome undergoing percutaneous coronary intervention.Frontiers in cardiovascular medicine · 2026Article
- The combined association of the neutrophil percentage-to-albumin ratio (NPAR) and the uric acid-to-high-density lipoprotein cholesterol ratio (UHR) with adverse cardiac events in patients with chronic heart failure: a retrospective cohort study.Lipids in health and disease · 2025Article
- Association between neutrophil percentage-to-albumin ratio and prostate cancer: A cross-sectional study.Medicine · 2025Article
- Sex-specific associations between Neutrophil-Percentage-to-Albumin Ratio(NPAR) and Neutrophil-to-Lymphocyte Ratio (NLR) with positive and negative symptoms in schizophrenia.BMC psychiatry · 2025Article
- Association between neutrophil percentage-to-albumin ratio and prevalence peripheral artery disease in U.S. adults: a cross-sectional study from the NHANES.BMC cardiovascular disorders · 2025Article
- Neutrophil-to-albumin ratio predicts long-term prognosis in coronary heart disease: a prospective cohort study of 2,990 patients.Frontiers in nutrition · 2025Article
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10 authors.
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Abstract
backgroundThe neutrophil percentage-to-albumin ratio (NPAR) has been identified as a prognostic indicator of mortality in various diseases; however, its association with all-cause and cardiovascular mortality in the general population remains insufficiently studied.
methodsThis retrospective cohort study analyzed data from 36,428 individuals who participated in the National Health and Nutrition Examination Survey between 1999 and 2018. Participants were divided into tertiles based on NPAR levels, with follow-up data collected through December 31, 2019. Weighted multivariable Cox regression models were employed to assess the associations between NPAR and both all-cause and cardiovascular mortality. Kaplan-Meier survival analyses were used to compare survival rates across NPAR tertiles. Additionally, restricted cubic spline analyses and subgroup and sensitivity analyses were conducted to further investigate these associations.
resultsDuring the follow-up period of up to 20 years, 4,716 deaths occurred among the 36,428 participants, including 1,260 deaths attributed to cardiovascular disease. At baseline, the mean NPAR was 13.66 (SD 2.42), the average age was 45.75 years (SD 16.20), and 50.33% of participants were female. Multivariable analyses showed that individuals in the highest NPAR tertile had a significantly increased risk of both all-cause mortality (HR, 95% CI: 1.45, 1.33-1.57) and cardiovascular mortality (HR, 95% CI: 1.69, 1.39-2.06). Kaplan-Meier survival curves demonstrated significant differences in both all-cause and cardiovascular mortality across NPAR groups. A nonlinear association was observed between NPAR and the risk of both all-cause and cardiovascular mortality. Sensitivity analyses confirmed the robustness of these associations. Additionally, a significant interaction between NPAR and hypertension was identified in relation to all-cause mortality (relative excess risk due to interaction, 95% CI: 0.20, 0.07-0.34; multiplicative interaction, P = 0.04).
conclusionsAn elevated baseline NPAR is independently associated with an increased risk of all-cause and cardiovascular mortality.
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