• Mengyao Hu, Zhuoyan Tong, Zhiyuan Cai, Shiyu Li, and Dongwei Yang.
• Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan, China.
• Medicine (Baltimore). 2025 Jan 24; 104 (4): e41352e41352.

AbstractInflammatory responses and lipid metabolism disorders are key components in the development of coronary artery disease and contribute to no-reflow after coronary intervention. This study aimed to investigate the association between the neutrophil to high-density lipoprotein ratio (NHR) and no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PPCI). This study enrolled 288 patients with STEMI from September 1st, 2022 to February 29th, 2024, in the Zhengzhou Central Hospital Affiliated to Zhengzhou University. According to postoperative thrombolysis in myocardial infarction flow grades, there were 221 patients in the normal flow group and 67 patients in the no-reflow group. Comparing the clinical data of the 2 groups, the independent risk factors of no-reflow phenomenon in STEMI patients after PPCI were determined by multivariate logistic regression analysis. Additionally, we assessed the diagnostic value of NHR for no-reflow using receiver operating characteristic curve analysis. The no-reflow phenomenon was observed in 67 patients with STEMI following PPCI, representing a prevalence of 23.26%. Compared with the normal group, NHR, as well as the rates of intracoronary thrombolysis and thrombus aspiration, were significantly elevated, while lymphocyte and albumin were lower (P < .05). Multivariate logistic regression analysis revealed that NHR was an independent risk factor for no-reflow (OR = 1.241, 95% CI: 1.142-1.349, P < .001). In the receiver operating characteristic curve of NHR diagnosis of no-reflow, the area under the curve (AUC) was 0.740 (95% CI: 0.671-0.809, P < .001), and the optimal critical value was 7.88, which indicates sensitivity and specificity were 71.6% and 71.50%. NHR may serve as a risk mark for STEMI patients with no-reflow after PPCI, and has diagnosis value for its occurrence.Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.

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