Neutrophil percentage-to-albumin ratio and monocyte-to-lymphocyte ratio as predictors of free-wall rupture in patients with acute myocardial infarction

Backgrounds Free-wall rupture (FWR) has a high mortality rate. We aimed to find sensitive predictive indicators to identify high-risk FWR patients by exploring the predictive values of neutrophil percentage-to-albumin ratio (NPAR) and monocyte-to-lymphocyte ratio (MLR) on patients with acute myocardial infarction (AMI). Methods 76 FWR patients with AMI were collected, and then 228 non-CR patients with AMI were randomly selected (1:3 ratio) in this retrospective study. The independent influencing factors of FWR were evaluated by univariate and multivariate logistic regression analysis. The receiver-operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of NPAR and MLR for FWR. Results According to the results of multivariate logistic regression analysis, emergency percutaneous coronary intervention (PCI) (OR = 0.27, 95% CI: 0.094-0.751, p = 0.012), angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) treatment (OR = 0.17, 95% CI: 0.044-0.659, p = 0.010), NPAR (OR = 2.69, 95% CI: 1.031-7.044, p = 0.043), and MLR (OR = 5.99, 95% CI: 2.09-17.168, p = 0.001) were the influencing factors of the FWR patients with AMI, independently. Additionally, the NPAR and MLR were the predictors of FWR patients, with AUC of 0.811 and 0.778, respectively (both p < 0.001). Conclusions In summary, the emergency PCI and ACEI/ARB treatment were independent protective factors for FWR patients with AMI, while the increase of MLR and NPAR were independent risk factors. What's more, NPAR and MLR are good indicators for predicting FWR.