Key result
Higher platelet-to-HDL-C ratio is linked to ~37% higher 10-year MACE risk.
Why the study?
The platelet-to-high-density-lipoprotein-cholesterol ratio (PHR) is a potential indicator of inflammatory and metabolic status, but evidence regarding its relationship with major adverse cardiovascular events (MACE) was limited.
Does a higher baseline platelet-to-high-density-lipoprotein-cholesterol ratio (PHR) predict an increased 10-year risk of major adverse cardiovascular events (MACE) in community-dwelling Chinese adults?
Cohort (n=8,184)
Does a higher baseline platelet-to-high-density-lipoprotein-cholesterol ratio (PHR) predict an increased 10-year risk of major adverse cardiovascular events (MACE) in community-dwelling Chinese adults?
Answers are grounded in this paper and cite their sources.
An elevated baseline platelet-to-HDL-C ratio (PHR) is independently associated with higher 10-year risks of MACE and acute myocardial infarction, supporting its utility as a simple, low-cost biomarker for long-term cardiovascular risk stratification.
Background: The platelet-to-high-density-lipoprotein-cholesterol ratio (PHR), a composite index integrating platelet count and HDL-C concentration, has recently attracted attention as a potential indicator of inflammatory and metabolic status. However, evidence regarding its relationship with major adverse cardiovascular events (MACE) is still limited. Therefore, using data from a prospective community-based cohort, we evaluated whether baseline PHR was associated with the occurrence of MACE during 10 years of follow-up. Methods: A total of 8,184 eligible subjects were included in our analysis. The primary outcome was MACE, and the secondary outcome was acute myocardial infarction (AMI), stroke, and CV mortality over 10 years. The PHR was calculated as the ratio of platelets to high-density-lipoprotein-cholesterol (HDL-C). Associations between baseline PHR and subsequent MACE were examined using multivariable Cox proportional hazards models, with effect estimates reported as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: Of all participants, the mean age was 56.4 ± 8.9 years, and 2,989 (36.5%) were men. During a mean 10-year follow-up, a total of 853 (10.4%) cases of MACE, 165 (2.0%) cases of AMI, 673 (8.2%) cases of stroke, and 143 (1.7%) cases of CV mortality were recorded. After multivariable adjustment, individuals in the highest PHR quartile showed a greater risk of MACE than those in the lowest quartile (HR: 1.37; 95% CI: 1.12-1.69). A similar association was observed for AMI, with the highest quartile having more than twice the risk of the lowest quartile (HR: 2.44; 95% CI: 1.43-4.18). In contrast, the corresponding associations with stroke (HR: 1.27; 95% CI: 1.00-1.60) and CV mortality (HR: 1.07; 95% CI: 0.65-1.77) were not statistically significant. Conclusions: These findings indicate that higher PHR is associated with an increased long-term risk of MACE and AMI among Chinese community-dwelling adults, suggesting that PHR may serve as a potential biomarker associated with cardiovascular risk.
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Dong et al. (2026) conducted a cohort in Cardiovascular risk in community-dwelling adults (n=8,184). Highest quartile of platelet-to-high-density-lipoprotein-cholesterol ratio (PHR ≥184.1) vs. Lowest quartile of platelet-to-high-density-lipoprotein-cholesterol ratio (PHR <116.4) was evaluated on Major adverse cardiovascular events (MACE: composite of cardiovascular mortality, stroke including TIA, and acute myocardial infarction) (HR 1.37, 95% CI 1.12-1.69, p=0.003). Higher baseline platelet-to-HDL-C ratio (Q4 vs Q1) was independently associated with an increased 10-year risk of MACE (HR 1.37, 95% CI 1.12-1.69, p=0.003) in Chinese community-dwelling adults.
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