{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:45:57Z","timestamp":1776746757663,"version":"3.51.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute aortic dissection (AAD) carries high early mortality, necessitating reliable prognostic tools. The neutrophil-to-albumin ratio (NPAR) synergistically encapsulates inflammatory activity and nutritional status, yet its prognostic utility in AAD remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled 415 patients with AAD diagnosed at Yuebei People's Hospital between January 2020 and December 2024. NPAR was calculated from admission laboratory values and analyzed as both a continuous and categorical variable (tertiles). Logistic regression models were used to assess the association between NPAR and 30-day mortality. Restricted cubic spline (RCS) analysis examined the dose\u2013response relationship. Receiver operating characteristic analysis compared NPAR with NLR, SII, and PLR. Prespecified subgroup analyses examined effect consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher NPAR values were independently associated with increased 30-day mortality (adjusted OR: 1.48; 95% CI: 1.05\u20132.09;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.027). Patients in the highest NPAR tertile (\u226522.37) had significantly greater mortality risk than those in the lowest tertile (&amp;lt;19.95) (adjusted OR: 20.28; 95% CI: 1.45\u2013283.0;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025). RCS analysis revealed a linear positive association between NPAR and mortality. NPAR demonstrated superior discrimination for 30-day mortality (AUC: 0.741) compared with NLR, SII, and PLR. Subgroup analyses yielded consistent associations across prespecified strata with no significant interactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated admission NPAR is an independent predictor of short-term mortality in AAD. As an easily available and inexpensive biomarker, NPAR may improve early risk stratification and guide clinical decision-making in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1791503","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:22:16Z","timestamp":1776745336000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil-to-albumin ratio predicts 30-day mortality in acute aortic dissection: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yunxian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiefan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baofeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liangqiu","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shebing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yue Bei People\u2019s Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association\/American College of Cardiology Joint Committee on clinical practice 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