Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction

BackgroundThe neutrophil to high-density lipoprotein cholesterol ratio (NHR) has been proposed as a potential marker for predicting cardiovascular events. However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction...

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Main Authors: Jianlin Chen, Anbang Liu, Dan Zhang, Tingting Meng, Xinhe Zhang, Weihong Xu, Yan Zheng, Guohai Su
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1497255/full
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author Jianlin Chen
Anbang Liu
Dan Zhang
Tingting Meng
Xinhe Zhang
Weihong Xu
Yan Zheng
Yan Zheng
Guohai Su
Guohai Su
Guohai Su
author_facet Jianlin Chen
Anbang Liu
Dan Zhang
Tingting Meng
Xinhe Zhang
Weihong Xu
Yan Zheng
Yan Zheng
Guohai Su
Guohai Su
Guohai Su
author_sort Jianlin Chen
collection DOAJ
description BackgroundThe neutrophil to high-density lipoprotein cholesterol ratio (NHR) has been proposed as a potential marker for predicting cardiovascular events. However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to evaluate the predictive value of NHR for left ventricular remodeling (LVR) and long-term outcomes in STEMI patients post-PCI.MethodsThis retrospective study included 299 STEMI patients who underwent PCI and were followed for 24 months post-procedure. Echocardiography was performed upon admission and at 6 months post-myocardial infarction (MI). LVR was defined as an increase in left ventricular diastolic volume (LVEDV) of at least 20% from baseline. Based on their VR status, patients were divided into LVR (n = 81) and non-LVR (n = 218) groups and clinical data were compared. A weighted logistic regression model was used to study the correlation between NHR and LVR. Weighted Cox proportional risk models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for major adverse cardiovascular events (MACE). And the NHR was analyzed using receiver operating characteristic (ROC) curves to predict the occurrence of postoperative LVR and MACE in STEMI patients. Restricted cubic spline (RCS) analysis was used to explore the linear or non-linear relationship between NHR and LVR or MACE. Cox survival analysis was used to assess the relationship between NHR, LVR and survival time.ResultsAmong the 299 STEMI patients enrolled in the study, LVR was observed in 81 patients after 24 months of follow-up. The LVR group had significantly higher NHR levels compared to the non-LVR group (8.19 ± 1.95 vs. 6.23 ± 1.91, P < 0.001). After adjusting for potential confounders, a significant positive correlation was found between NHR and LVR. Each standard deviation increase in NHR was associated with a 43% higher risk of MACE (HR: 1.43, 95% CI: 1.25–1.64, P < 0.001). ROC curve analysis demonstrated that NHR could predict both LVR (AUC: 0.762) and MACE (AUC: 0.722). An NHR cut-off value of >8.13 was significantly linked to an increased risk of MACE (HR: 4.30, 95% CI: 2.41–7.69).ConclusionsNHR is an independent predictor of LVR and MACE after PCI in STEMI patients. Monitoring NHR may aid in identifying high-risk patients early, facilitating individualized treatment.
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spelling doaj-art-c4f961acf4bc4798ad4b645c8efcc41d2025-08-20T01:55:11ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-04-011210.3389/fcvm.2025.14972551497255Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarctionJianlin Chen0Anbang Liu1Dan Zhang2Tingting Meng3Xinhe Zhang4Weihong Xu5Yan Zheng6Yan Zheng7Guohai Su8Guohai Su9Guohai Su10School of Clinical Medicine, Shandong Second Medical University, Weifang, ChinaShandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, ChinaDepartment of Cardiovascular Medicine, Jinan Central Hospital, Jinan, Shandong, ChinaShandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, ChinaShandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, ChinaShandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, ChinaDepartment of Cardiovascular Medicine, Jinan Central Hospital, Jinan, Shandong, ChinaResearch Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaSchool of Clinical Medicine, Shandong Second Medical University, Weifang, ChinaDepartment of Cardiovascular Medicine, Jinan Central Hospital, Jinan, Shandong, ChinaResearch Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaBackgroundThe neutrophil to high-density lipoprotein cholesterol ratio (NHR) has been proposed as a potential marker for predicting cardiovascular events. However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to evaluate the predictive value of NHR for left ventricular remodeling (LVR) and long-term outcomes in STEMI patients post-PCI.MethodsThis retrospective study included 299 STEMI patients who underwent PCI and were followed for 24 months post-procedure. Echocardiography was performed upon admission and at 6 months post-myocardial infarction (MI). LVR was defined as an increase in left ventricular diastolic volume (LVEDV) of at least 20% from baseline. Based on their VR status, patients were divided into LVR (n = 81) and non-LVR (n = 218) groups and clinical data were compared. A weighted logistic regression model was used to study the correlation between NHR and LVR. Weighted Cox proportional risk models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for major adverse cardiovascular events (MACE). And the NHR was analyzed using receiver operating characteristic (ROC) curves to predict the occurrence of postoperative LVR and MACE in STEMI patients. Restricted cubic spline (RCS) analysis was used to explore the linear or non-linear relationship between NHR and LVR or MACE. Cox survival analysis was used to assess the relationship between NHR, LVR and survival time.ResultsAmong the 299 STEMI patients enrolled in the study, LVR was observed in 81 patients after 24 months of follow-up. The LVR group had significantly higher NHR levels compared to the non-LVR group (8.19 ± 1.95 vs. 6.23 ± 1.91, P < 0.001). After adjusting for potential confounders, a significant positive correlation was found between NHR and LVR. Each standard deviation increase in NHR was associated with a 43% higher risk of MACE (HR: 1.43, 95% CI: 1.25–1.64, P < 0.001). ROC curve analysis demonstrated that NHR could predict both LVR (AUC: 0.762) and MACE (AUC: 0.722). An NHR cut-off value of >8.13 was significantly linked to an increased risk of MACE (HR: 4.30, 95% CI: 2.41–7.69).ConclusionsNHR is an independent predictor of LVR and MACE after PCI in STEMI patients. Monitoring NHR may aid in identifying high-risk patients early, facilitating individualized treatment.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1497255/fullmyocardial infarctionventricular remodelingneutrophil to high-density lipoprotein cholesterol ratiobiomarkermajor adverse cardiovascular events
spellingShingle Jianlin Chen
Anbang Liu
Dan Zhang
Tingting Meng
Xinhe Zhang
Weihong Xu
Yan Zheng
Yan Zheng
Guohai Su
Guohai Su
Guohai Su
Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
Frontiers in Cardiovascular Medicine
myocardial infarction
ventricular remodeling
neutrophil to high-density lipoprotein cholesterol ratio
biomarker
major adverse cardiovascular events
title Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
title_full Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
title_fullStr Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
title_full_unstemmed Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
title_short Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction
title_sort neutrophil to high density lipoprotein cholesterol ratio predicts left ventricular remodeling and mace after pci in patients with acute st segment elevation myocardial infarction
topic myocardial infarction
ventricular remodeling
neutrophil to high-density lipoprotein cholesterol ratio
biomarker
major adverse cardiovascular events
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1497255/full
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