Relationship between Systemic Inflammatory Biomarkers and LAD Plaque Lesion Localization and Severity in Patients with Acute ST-segment Elevation Myocardial Infarction

Introduction: Acute ST-segment elevation myocardial infarction (STEMI) is a leading cause of mortality, driven by coronary artery disease and inflammation. Systemic inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-albumin ratio (CAR), are linked to lesion severity and localization in the left anterior descending (LAD) artery, but local data from Pakistan are scarce. Objective: To assess the relationship between systemic inflammatory biomarkers (NLR, PLR, CAR) and the localization and severity of LAD plaque lesions in STEMI patients. Material and Methods: This retrospective study at Dr. Ruth K.M. Pfau Civil Hospital, Karachi from April, 2024 to September, 2024, included 87 STEMI patients with proximal or mid-LAD lesions. Biomarkers were correlated with angiographic findings using SPSS version 23.0. Results: Proximal LAD lesions (N=53) showed higher median NLR (3.00 vs. 1.50), PLR (109.75 vs. 70.00), and CAR (35.71 vs. 14.00) compared to mid-LAD lesions (N=33), indicating greater inflammatory burden (p<0.05). Conclusion: Elevated NLR, PLR, and CAR are associated with proximal LAD lesions, offering cost-effective risk stratification tools for STEMI patients in resource-limited settings.