Objective:

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), highlighting their potential impact on clinical outcomes.

Key Findings:

• PHR and WMR levels were significantly higher in the STEMI group than in controls (P < 0.05), indicating a potential role in risk assessment.
• PHR was significantly lower in the multi-vessel group compared to double- and single-vessel groups (P < 0.05), suggesting its relevance in stratifying disease severity.
• PHR showed a negative correlation with the number of lesions (r = −0.672, P < 0.001) and severity (r = −0.400, P < 0.001), reinforcing its prognostic value.
• Multivariate analysis identified PHR as an independent risk factor for acute STEMI (OR 1.069, P = 0.049) and for moderate-to-severe coronary lesions (OR 0.958, P < 0.001).
• PHR demonstrated moderate predictive value for STEMI occurrence and severity, with AUCs of 0.756, 0.881, and 0.870, indicating its utility in clinical settings.
• WMR was a useful predictor specifically for the occurrence of STEMI (AUC = 0.951, P < 0.001), highlighting its potential as a diagnostic tool.

Interpretation:

A lower PHR is associated with a greater number and severity of coronary lesions in STEMI patients, indicating its potential as a prognostic marker that could guide clinical decision-making.

Limitations:

• The study is limited by its retrospective design, which may introduce biases.
• The sample size may not be representative of all STEMI patients, potentially affecting the generalizability of the findings.

Conclusion:

PHR and WMR are predictive of STEMI occurrence, with PHR being an important predictor of the number and severity of diseased coronary vessels, suggesting their integration into clinical practice for better risk stratification.