Loading
Acute Coronary Syndrome · Journal article
Annals of Medicine · July 24, 2026
Encouraging direction, but not yet definitive.
This single-centre retrospective cohort study of 1326 ACS patients reports a significant nonlinear (U-shaped) association between platelet-to-albumin ratio and one-year all-cause mortality, with an inflection point at PAR 5.28. The finding is based on a hard endpoint and adequate sample size, but observational design and single-centre recruitment limit the strength of evidence and generalizability.
Single-centre, retrospective cohort study. Patients diagnosed with ACS (UA, NSTEMI, or STEMI) enrolled between January 2022 and December 2023 at a single centre in China; median age 67 years.. Intervention: Platelet-to-albumin ratio (admission measurement). n = 1,326. Single centre: The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China..
One-year all-cause mortality occurred in 137 of 1326 participants (10.3%); rates by PAR quartile were 11.6% (Q1), 6.1% (Q2), 7.0% (Q3), and 16.7% (Q4). MACCE occurred in 280 of 1326 participants (21.1%); rates by quartile were 22.1%, 15.2%, 18.7%, and 28.5%. RCS analysis revealed significant nonlinear associations between PAR and both endpoints (p for nonlinear 0.05).
No reported external validation or comparison with prior PAR mortality studies. Hazard ratios and effect sizes not reported in excerpt; only descriptive mortality rates by quartile provided.
Clinicians should recognize that platelet-to-albumin ratio, a readily available composite biomarker, shows an inverted U-shaped relationship with one-year mortality risk in ACS patients, suggesting both low and high ratios may indicate increased risk. However, this finding requires validation in external cohorts before incorporation into routine risk stratification.
A single-centre retrospective cohort study identifying a nonlinear association between a novel composite biomarker and one-year mortality in ACS, with adequate sample size and hard endpoint, but limited by observational design and lack of external validation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that platelet-to-albumin ratio, a readily available composite biomarker, shows an inverted U-shaped relationship with one-year mortality risk in ACS patients, suggesting both low and high ratios may indicate increased risk. However, this finding requires validation in external cohorts before incorporation into routine risk stratification.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. The platelet-to-albumin ratio (PAR) has shown to be linked with cardiovascular disorders. However, the specific association between the admission PAR and one-year outcomes in patients with acute coronary syndrome (ACS) remains to be fully characterized. This study investigated the linkage between PAR levels and the occurrence of one-year all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCEs) in the ACS population.Patients and methods. This retrospective cohort study enrolled patients diagnosed with ACS between January 2022 and December 2023. The primary endpoint was one-year all-cause mortality, and the secondary endpoint was MACCE, defined as a composite of all-cause mortality, non-fatal myocardial infarction, ischemic stroke, heart failure rehospitalization, target vessel revascularization or in-stent thrombosis, and malignant arrhythmia. To evaluate the relationship between PAR and these clinical events, we employed multivariate Cox proportional hazards models, restricted cubic splines (RCSs) and two-piecewise linear regression to identify potential non-linear associations and specific inflection points.Results. A total of 1326 participants (median age: 67 years) were followed for one year, during which 137 (10.3%) deaths and 280 (21.1%) MACCE events occurred. The one-year all-cause mortality rates across the PAR quartiles (Q1-Q4) were 11.6%, 6.1%, 7.0% and 16.7%, respectively, with a similar trend observed for MACCE (22.1%, 15.2%, 18.7% and 28.5%). RCS analysis revealed significant nonlinear associations between the PAR and both clinical endpoints (all p for nonlinear < 0.05). Two-piecewise linear regression analysis identified specific inflection points at 5.28 (95% confidence interval [CI]: 4.86-9.86) for one-year all-cause mortality and 5.29 (95% CI: 4.37-6.58) for MACCE.Conclusions. The PAR demonstrates a significant nonlinear relationship with one-year all-cause mortality and MACCE in patients with ACS.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.