The predictive value of platelet-to-high density lipoprotein cholesterol ratio and white blood cell-to-mean platelet volume ratio for coronary artery disease risk in STEMI patients

Background This study aimed to evaluate the prognostic value of the platelet count to high-density lipoprotein cholesterol ratio (PHR) and the white blood cell count to mean platelet volume ratio (WMR) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods We enrolled 87 acute STEMI patients (STEMI group) and 100 healthy individuals (control group). The STEMI group was stratified by the number of coronary artery lesions (single-, double-, or multi-vessel) and by disease severity using the Gensini score (mild, moderate, severe). Clinical data were compared, and statistical analyses were performed. Results (I) PHR and WMR levels were significantly higher in the STEMI group than in controls ( P < 0.05). However, PHR was significantly lower in the multi-vessel group than in the double- and single-vessel groups ( P < 0.05), and lower in moderate/severe groups than in the mild group ( P < 0.05). (II) PHR showed a negative correlation with the number of lesions ( r = −0.672, P < 0.001) and severity ( r = −0.400, P < 0.001). (III) Multivariate analysis identified PHR as an independent risk factor for both acute STEMI (OR 1.069, 95% CI 1.069–1.143, P = 0.049) and for moderate-to-severe coronary lesions (OR 0.958, 95% CI 0.938–0.979, P < 0.001). (IV) On the ROC curve, PHR demonstrated moderate predictive value for the occurrence of STEMI, involvement of two or more diseased vessels, and moderate-to-severe coronary lesions, with AUCs of 0.756, 0.881, and 0.870, respectively (all P < 0.001). Meanwhile, WMR was found to be a useful predictor specifically for the occurrence of STEMI (AUC = 0.951, P < 0.001). Conclusions A lower PHR is associated with a greater number and severity of coronary lesions in STEMI patients. PHR and WMR are predictive of STEMI occurrence, and PHR is an important predictor of the number and severity of diseased coronary vessels.