Neutrophil Percentage/Albumin Ratio as an Independent Predictor of the No-Reflow Phenomenon in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Abstract
1. Introduction
2. Material and Methods
2.1. Criteria for Participant Inclusion
2.2. Data Collection and Definitions
2.3. Definition of the No-Reflow Phenomenon
2.4. Coronary Diagnostic Imaging and Percutaneous Intervention
2.5. Medication Protocols
2.6. Biochemical Testing and Cardiac Ultrasound Analysis
3. Statistical Analysis
4. Results
5. Discussion
6. Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Normal-Reflow n = 653 | No-Reflow n = 105 | p Value | |
---|---|---|---|
Age (year) | 54 (45–62) | 60 (53–67) | <0.001 |
Male (n, %) | 461 (71%) | 79 (75.2%) | 0.33 |
Hypertension (n, %) | 362 (55.4) | 64 (60.1%) | 0.089 |
DM (n, %) | 258 (39.5%) | 42 (40%) | 0.815 |
Dyslipidemia (n, %) | 87 (13.3%) | 18 (17.1%) | 0.318 |
CAD (n, %) | 124 (19%) | 26 (24.7%) | 0.655 |
Smokers (n, %) | 315 (48.2%) | 49 (46.6%) | 0.354 |
LVEF (%) | 39.2 ± 6.9 | 31.8 ± 5.1 | <0.001 |
Killip III–IV (n, %) | 29 (4.4%) | 9 (8.2%) | 0.062 |
BMI (kg/m2) | 26.5 (23.6–30.8) | 28.4 (26–31) | <0.001 |
Glomerular filtration rate (mL/min/1.73 m2) | 85.29 ± 39.4 | 81.9 ± 37.2 | 0.17 |
Serum Glucose (mg/dL) | 109.29 ± 68.6 | 129.5 ± 34.5 | 0.144 |
Total cholesterol (mg/dL) | 156.3 (132–179) | 175 (141–210) | 0.291 |
High-density lipoprotein cholesterol (mg/dL) | 39 (29–47) | 37 (31–45) | 0.713 |
Low-density lipoprotein cholesterol (mg/dL) | 101 (79–135) | 106 (82–176) | 0.645 |
Triglyceride (mg/dL) | 129 (83–211) | 144 (91–233) | 0.536 |
Albumin (mg/dL) | 4.2 (3.5–4.4) | 3.9 (3.5–4.1) | 0.021 |
Hemoglobin (g/L) | 14.2 (13.3–15.2) | 14.3 (12.9–15.1) | 0.883 |
Platelet (103/μL) | 220 (188–263) | 227 (187–257) | 0.716 |
WBC (103/μL) | 7.4 (5.8–8.9) | 12.3 (9.6–16.9) | <0.001 |
Neutrophil (103/μL) | 4.1 (3.3–6.9) | 7 (4.5–13.5) | <0.001 |
Neutrophil percentage (%) | 67.2 (45.2–75.3) | 81.9 (66.9–89.1) | <0.001 |
Lymphocyte (103/μL) | 1.8 (1.3–2.5) | 1.7 (1.3–2.3) | 0.168 |
CRP (mg/dL) | 3.2 (2.4–6) | 5 (3.6–8) | <0.001 |
NLR | 2.1 (1.5–3) | 4.6 (2.9–9.6) | <0.001 |
NPAR | 16.32 ± 4.14 | 21.01 ± 3.65 | <0.001 |
CAR | 0.75 (0.59–1.7) | 1.1 (0.74–2.1) | <0.001 |
Infarct Related Artery | |||
---|---|---|---|
LAD | 76 (49%) | 113 (45%) | 0.322 |
RCA | 42 (27%) | 71 (28%) | 0.843 |
CX | 35 (23%) | 67 (26%) | 0.334 |
Coronary artery involvement | |||
Stent length (mm) | 21.1 ± 5.4 | 20.6 ± 6.7 | 0.139 |
Stent diameter (mm) | 2.54 ± 0.85 | 2.61 ± 0.73 | 0.380 |
Predilation | 103 (67%) | 148 (60%) | 0.113 |
Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|
Variables | Unadjusted OR | 95% CI | p Value | Adjusted OR | 95% CI | p Value |
Age | 1.057 | 1.036–1.079 | <0.001 | 1.108 | 1.072–1.144 | <0.001 |
BMI | 1.063 | 1.018–1.111 | 0.006 | 1.016 | 1.011–1.148 | 0.022 |
LVEF | 0.592 | 0.345–0.878 | 0.026 | |||
Albumin | 0.488 | 0.303–0.786 | 0.003 | |||
WBC | 1.403 | 1.312–1.501 | <0.001 | |||
Neutrophil | 1.501 | 1.386–1.625 | <0.001 | |||
Neutrophil percentage | 3.625 | 2.982–5.193 | <0.001 | |||
CRP | 1.068 | 1.020–1.119 | 0.005 | |||
NLR * | 1.324 | 1.245–1.408 | <0.001 | 1.158 | 1.074–1.249 | <0.001 |
NPAR * | 4.622 | 3.452–6.190 | <0.001 | 5.482 | 3.254–9.234 | <0.001 |
CAR | 1.369 | 1.137–1.647 | 0.001 | 1.344 | 1.024–1.763 | 0.033 |
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Yavcin, O.; Yilmaz, Y. Neutrophil Percentage/Albumin Ratio as an Independent Predictor of the No-Reflow Phenomenon in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Diagnostics 2025, 15, 2609. https://doi.org/10.3390/diagnostics15202609
Yavcin O, Yilmaz Y. Neutrophil Percentage/Albumin Ratio as an Independent Predictor of the No-Reflow Phenomenon in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Diagnostics. 2025; 15(20):2609. https://doi.org/10.3390/diagnostics15202609
Chicago/Turabian StyleYavcin, Ozkan, and Yucel Yilmaz. 2025. "Neutrophil Percentage/Albumin Ratio as an Independent Predictor of the No-Reflow Phenomenon in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention" Diagnostics 15, no. 20: 2609. https://doi.org/10.3390/diagnostics15202609
APA StyleYavcin, O., & Yilmaz, Y. (2025). Neutrophil Percentage/Albumin Ratio as an Independent Predictor of the No-Reflow Phenomenon in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Diagnostics, 15(20), 2609. https://doi.org/10.3390/diagnostics15202609