Acute ST elevation myocardial infarction (STEMI) is a serious coronary artery disease whose prognosis is influenced by many factors. Inflammation plays an important role in the development of STEMI, and platelet/lymphocyte ratio (PLR) and white blood cell/lymphocyte ratio (WLR) are potential markers of inflammation. This study was designed to investigate the association between PLR and WLR and the risk of major adverse cardiac events (MACE) during hospitalization in STEMI patients.

This study retrospectively analyzed the clinical data of 403 STEMI patients who underwent percutaneous coronary intervention (PCI). Patients were divided into MACE group (n=71) and non-MACE group (n=332) according to whether MACE occurred during their hospitalization. Baseline data, laboratory indicators, angiographic results, and the occurrence of MACE during hospitalization were collected. Spearman correlation analysis was used to evaluate the correlation between PLR, WLR and MACE risk and other clinical indicators. Univariate and multivariate Logistic regression analyses were used to determine independent predictors of MACE occurrence.

1. There was no significant difference in baseline data between the two groups (P>0.05). PLR and WLR in MACE group were significantly higher than those in non-MACE group (P<0.001). In addition, Gensini score, SYNTAX score, TIMI blood flow grade 0 ratio, CFR and IMR in MACE group were significantly lower than those in non-MACE group (P<0.05).2. Patients were divided into high and low groups according to the median of PLR and WLR. The Gensini score, SYNTAX score, TIMI grade 0 ratio, CFR and IMR of high PLR group and high WLR group were significantly lower than those of low PLR group and low WLR group (P<0.05).3. Spearman correlation analysis showed that PLR, WLR, Gensini score, SYNTAX score, TIMI blood flow grade and IMR were positively correlated with the occurrence of MACE (P<0.05), while CFR was negatively correlated with the occurrence of MACE (P<0.05). These correlations persisted in subgroup analyses of high PLR levels and high WLR levels.4. Univariate Logistic regression analysis showed that PLR, WLR, Gensini score, SYNTAX score, CFR, IMR and TIMI grade 2 were risk factors for MACE (P<0.05). Multivariate Logistic regression analysis further confirmed that PLR (OR=1.992, 95%CI: 1.483-2.675, P<0.001), WLR (OR=2.386, 95%CI: 1.329-3.258, P<0.001) and CFR (OR=0.790, 95%CI: 0.487-0.967, P<0.001) were independent predictors of MACE occurrence.

PLR and WLR were independent predictors of MACE during hospitalization in STEMI patients. Higher PLR and WLR are associated with more severe coronary artery disease, poorer microcirculatory function, and a higher risk of MACE. Therefore, PLR and WLR can be used as potential indicators to predict the prognosis of STEMI patients and provide a reference for clinicians to formulate an individualized treatment plan.