Prognostic Significance of the Neutrophil Percentage-to-Albumin Ratio in Ischemic Stroke Mortality

Аннотация

Ischemic stroke remains a leading cause of Stroke Mortality. The American Journal of Medical Sciences and Pharmaceutical Research, 7(06), 01–08. Retrieved from mortality and long-term disability globally, necessitating https://theamericanjournals.com/index.php/tajmspr/article/view/6218 reliable prognostic markers for effective patient management and therapeutic stratification. This article COPYRIGHT explores the emerging role of the Neutrophil © 2025 Original content from this work may be used under the terms Percentage-to-Albumin Ratio (NPAR) as a novel and of the creative commons attributes 4.0 License. readily accessible prognostic indicator for mortality in patients suffering from ischemic stroke. Drawing upon current literature, we delve into the intricate pathophysiology of ischemic stroke, emphasizing the dual roles of inflammation (mediated by neutrophils) and protective mechanisms (attributed to albumin). The discussion highlights how an elevated NPAR reflects a heightened pro-inflammatory state and diminished antioxidant capacity, both detrimental in the acute phase of stroke. Evidence from various cardiovascular and critical illness contexts, alongside specific findings in ischemic stroke, supports NPAR's utility in predicting not only mortality but also stroke-associated infections and poor functional outcomes. This review synthesizes the current understanding of NPAR's predictive power, its underlying biological mechanisms, and discusses its potential clinical implications, while acknowledging the need for further large-scale prospective studies to validate its widespread application in clinical practice. The American Journal of Medical Sciences and Pharmaceutical Research 1 https://www.theamericanjournals.com/index.php/tajmspr The American Journal of Medical Sciences and Pharmaceutical Research Keywords: Prognostic significance, neutrophil the body's inflammatory and nutritional status [13]. percentage-to-albumin ratio, ischemic stroke, stroke Elevated NPAR has been linked to adverse outcomes in mortality, inflammation, biomarkers, clinical outcome, various cardiovascular conditions, including coronary stroke prognosis atherosclerosis, atrial fibrillation, heart failure, and acute myocardial infarction [14, 15, 16, 17, 18]. Its potential predictive value in ischemic stroke, particularly INTRODUCTION - Ischemic stroke, characterized by the concerning mortality, is an area of growing interest [19, interruption of blood supply to a part of the brain, 20, 21, 22]. represents a significant global health burden, being a This article aims to synthesize the current understanding leading cause of mortality and severe long-term of the Neutrophil Percentage-to-Albumin Ratio (NPAR) neurological disability [1]. The incidence and prevalence and its prognostic significance for mortality in ischemic of stroke continue to pose substantial challenges to stroke patients. We will explore the roles of neutrophils healthcare systems worldwide, particularly in regions and albumin in stroke pathophysiology, review existing like South, East, and South-East Asia [1]. While evidence supporting NPAR's predictive capabilities, advancements in acute stroke management, including discuss the proposed underlying mechanisms, and endovascular therapies, have improved patient highlight the clinical implications and future research outcomes, predicting the prognosis, especially directions for this promising biomarker. mortality, remains a critical aspect of clinical decision- making and resource allocation [2, 10]. Intensive care METHODS unit (ICU) admissions for acute ischemic stroke patients are often associated with high costs and variable This study was conducted as a comprehensive literature outcomes, underscoring the need for effective review, aiming to synthesize existing research on the prognostic tools [4]. Neutrophil Percentage-to-Albumin Ratio (NPAR) as a The pathophysiology of ischemic stroke is complex, prognostic marker for mortality in ischemic stroke involving a cascade of events initiated by cerebral patients. The methodology involved a systematic ischemia, followed by reperfusion injury in many cases. approach to identify, select, and critically analyze A pivotal component of this cascade is the inflammatory relevant scientific literature. response, which significantly contributes to secondary • Search Strategy: A targeted search was performed brain damage [3, 25]. This inflammatory process across major electronic databases, including involves the rapid recruitment and activation of various PubMed, Google Scholar, and ResearchGate. immune cells, including neutrophils, which play a dual Keywords and phrases used in various combinations role in both protective and detrimental processes [6, 11, included: "ischemic stroke," "neutrophil 29]. Simultaneously, serum albumin, a highly abundant percentage-to-albumin ratio," "NPAR," "prognostic plasma protein, exerts crucial antioxidant, anti- marker," "mortality," "outcom