Clinical Value of Peripheral Blood NAR Combined with RAR in Predicting Restenosis after Percutaneous Transluminal Angioplasty of Arteriovenous Fistula
LU Yun
CHENG Zhengtao
QI Longwei
LI Guiying
WANG Xiaoying
WANG Taoxia
LI Jianwei
Abstract：Objective To explore the clinical value of the neutrophil-to-apolipoprotein A1 ratio(NAR)combined with the red blood cell distribution width-to-albumin ratio(RAR)in predicting restenosis after percutaneous transluminal angioplasty(PTA)of arteriovenous fistula.Methods A total of 182 patients with arteriovenous fistula dysfunction who underwent PTA at Affiliated Hospital of Hebei University of Engineering from April 2021 to May 2024 were enrolled.Patients were followed up for one year postoperatively and divided into a patency group(95 case)and a restenosis group(87 case)based on the occurrence of restenosis.Preoperative peripheral blood levels of neutrophils,apolipoprotein A1,red blood cell distribution width(RDW),and albumin were measured to calculate NAR and RAR.Predictive value was analyzed using ROC curves,and influencing factors were assessed by multivariate Logistic stepwise regression analysis.Results The restenosis rate was 47.80%among the 182 patients.Peripheral blood NAR and RAR were significantly higher in the restenosis group than in the patency group(P<0.05).ROC curve analysis showed AUC of 0.774 and 0.839 for NAR and RAR alone,respectively,in predicting restenosis.The combined prediction using NAR and RAR yielded an AUC of 0.906,which was significantly better than either alone(Z=12.905,10.029,P<0.001).Multivariate Logistic stepwise regression analysis identified comorbid diabetes,low lymphocyte,NAR≥3.15,and RAR≥0.43 as independent risk factors for restenosis(OR=2.195,95%CI:1.290-3.733,P=0.004;OR=2.519,95%CI:1.441-4.404,P=0.001;OR=2.861,95%CI:1.708-4.790,P<0.001;OR=3.133,95%CI:1.747-5.619,P<0.001).Conclusion Elevated peripheral blood NAR and RAR are independent risk factors for restenosis after PTA of arteriovenous fistula.The combination of NAR and RAR has high clinical value in predicting post-PTA restenosis.
Keywords：neutrophil-to-apolipoprotein A1 ratiored blood cell distribution width-to-albumin ratioarteriovenous fistulapercutaneous transluminal angioplastyrestenosispredictive value
Publication Date：2025-08-20
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：5( 20-24 )