Between the Neutrophil-to-Platelet Ratio and Short-Term Prognosis in Patients with ST-Segment Elevation Myocardial Infarction

Abstract Background The neutrophil-to-platelet ratio (NPR) is an emerging marker of systemic inflammation with potential prognostic value in acute coronary syndromes. This study aimed to assess the association between NPR at admission and 30-day all-cause mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials and Methods In this retrospective, single-centre study , a total of 413 patients diagnosed with STEMI between 2012 and 2017 were included. All patients underwent primary PCI. Venous blood samples were collected at admission, prior to PCI and antiplatelet therapy , to determine NPR values. Patients were followed up for 30 days and categorized into an all-cause mortality group and a survival group. A receiver operating characteristic (ROC) curve was used to establish the NPR cut-off value, which was then used to classify patients into high NPR and low NPR groups. Multivariate logistic regression analysis was performed to assess NPR as an independent predictor of 30-day all-cause mortality, adjusting for age, sex, and left ventricular ejection fraction. Results Among the 413 patients, 24 (5.8%) died within 30 days. NPR was significantly higher in the all-cause mortality group compared to the survival group (0.0513 ± 0.0215 vs 0.0398 ± 0.0183, P = 0.018). Based on ROC curve analysis, the NPR cut-off value was determined to be 0.0396, dividing patients into high NPR (196 patients) and low NPR (217 patients) groups. The incidence of endpoint events was significantly higher in the high NPR group compared to the low NPR group (9.2% vs 2.8%, P = 0.005). Multivariate logistic regression analysis confirmed that a high NPR was an independent predictor of 30-day all-cause mortality (odds ratio = 4.595, 95% CI: 1.662–12.702, P = 0.003). The AUC was 0.668 (95% CI: 0.55–0.77), with a sensitivity of 75% and specificity of 64%. Conclusion- An elevated NPR at admission was independently associated with 30-day mortality in STEMI patients treated with PCI. NPR may serve as a simple, cost-effective biomarker for early risk stratification in this high-risk population.