The non-HDL-C/HDL-C ratio is a strong and independent predictor of the no-reflow phenomenon in patients with ST-elevation myocardial infarction

Abstract

Background

No-reflow (NR) is the inability to achieve adequate myocardial perfusion despite successful restoration of attegrade blood flow in the infarct-related artery after primary percutaneous coronary intervention. The non-HDL-C/HDL-C ratio has been shown to be superior to conventional lipid markers in predicting most cardiovascular diseases. In this study, we wanted to reveal the predictive value of the NR by comparing the Non-HDL-C/HDL-C ratio with traditional and non-traditional lipid markers in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-elevation myocardial infarction (STEMI).

Methods

A total of 1284 consecutive patients who underwent pPCI for STEMI were included in this study. Traditional lipid profiles were detected and non-traditional lipid indices were calculated. Patients were classified as groups with and without NR and compared in terms of lipid profiles.

Results

No-reflow was seen in 18.8% of the patients. SYNTAX score, maximal stent length, high thrombus burden, atherogenic index of plasma and non-HDL-C/HDL-C ratio were determined as independent predictors for NR (p < 0.05, for all). The non-HDL-C/HDL-C ratio predicts the development of NR in STEMI patients with 71% sensitivity and 67% specificity at the best cut-off value. In ROC curve analysis, the non-HDL-C/HDL-C ratio was superior to traditional and non-traditional lipid markers in predicting NR (p < 0.05, for all).

Conclusion

The non-HDL-C/HDL-C ratio can be a strong and independent predictor of NR in STEMI patients and and therefore non-HDL-C/HDL-C ratio may be a useful lipid-based biomarker that can be used in clinical practice to improve the accuracy of risk assessment in patients with STEMI.

Keywords:

• Non-HDL-C/HDL-C ratio
• ST-elevation myocardial infarction
• non-traditional lipids
• no-reflow phenomenon

Authors’ contributions

Concept/Design—KT, MK, SA, Mİ, TM; Analysis/Interpretation—KT, MK,SA, MBÇ, AB, RD; Data Collection—KT, MK, SA, Mİ, TM, MBÇ, İHA, AB, RD; Writing—KT,MK, İHA, AB, RD; Critical Revision—KT, MBÇ, İHA, AB, RD; Final Approval—All of the authors; Statistical Analysis—KT, MBÇ,İHA, RD; Overall Responsibility—All of the authors. All authors contributed to the planning, conduct, and reporting of the work. All contributors are responsible for the overall content as guarantors.

Disclosure statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data availability statement

If a reasonable request to the corresponding author might share data of the study.

Additional information

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.