Objective To evaluate the impact of neutrophil percentage-to-albumin ratio(NPAR)on all-cause mortality in patients with chronic heart failure(CHF),and to analyze its correlation with prognosis in patients with three different types of CHF.Methods This was a retrospective study.A total of 622 patients with CHF admitted to the Department of Cardiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University from 2011 to 2016 were continuously enrolled,including 268 patients with reduced ejection fraction(HFrEF),111 patients with midrange ejection fraction(HFmrEF)and 243 patients with preserved ejection fraction(HFpEF).The NPAR values of patients within 24 h after admission were collected and divided into 209 cases in NPAR≤18.0 group,207 cases in 18.0<NPAR<21.2 group and 206 cases in NPAR≥21.2 group according to the tripartite.Patients were followed up by telephone and outpatient visits.The outcomes were defined as 90-day,1-year and 2-year all-cause mortality after discharge.Kaplan-Meier survival curves were used to compare the all-cause mortality of CHF patients with different NPAR levels.Multivariate Cox proportional hazard regression models were used to verify the effect of NPAR on all-cause mortality in patients with three different types of CHF.Results None of the 622 patients were lost during the follow-up.The median NPAR of patients was 19.7,which varied from 7.8 to 44.9.The 90-day,1-year,and 2-year all-cause mortality of CHF patients was 7.7%,19.6%and 27.8%,respectively.All-cause mortality at 90 days(P=0.009),1 year(P<0.001),and 2 years(P<0.001)in CHF patients increased with the increase of admission NPAR.Multivariate Cox regression analysis found that high NPAR were significantly associated with 90-day(HR=1.15,95%CI:1.05-1.25,P=0.003),1-year(HR=1.08,95%CI:1.04-1.14,P=0.004)and 2-year all-cause mortality(HR=1.05,95%CI:1.01-1.10,P=0.016)in HFpEF patients,significantly associated with 2-year all-cause mortality in HFmrEF patients(HR=1.10,95%CI:1.02-1.18,P=0.016),and no correlation with the prognosis of HFrEF patients.Conclusions Admitted NPAR is independently associated with all-cause mortality at 90 days,1 year,and 2 years in CHF patients.Admitted NPAR is associated with short-and long-term outcomes in HFpEF patients and with long-term outcomes in HFmrEF patients,and may be an independent predictor of clinical outcomes.
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