Frequency of Multivessel Coronary Artery Disease and Its Association with Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients with ST-Segment Elevation Myocardial Infarction.
DOI:
https://doi.org/10.58889/PJCVI.5.2.13.25Keywords:
STEMI, Multivessel Disease, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, SYNTAX ScoreAbstract
Background: To determine the frequency of multivessel coronary artery disease and evaluate its association with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients presenting with ST-segment elevation myocardial infarction (STEMI).
Methodology: This prospective observational cross-sectional study was conducted at Liaquat National Hospital and Medicare Cardiac and General Hospital, Karachi, from September 2024 to March 2025. A total of 150 consecutive patients aged 20–80 years presenting with STEMI and undergoing primary percutaneous coronary intervention (PCI) were enrolled. Baseline demographic characteristics, clinical variables, laboratory parameters, and angiographic findings were recorded. NLR and PLR were calculated from admission complete blood counts. The anatomical complexity of coronary artery disease was assessed using the SYNTAX score, which was calculated independently by two blinded interventional cardiologists and categorized into low (<22), intermediate (22–33), and high (>33) groups.
Results: Multivessel disease was highly prevalent, occurring in 91% of patients, with a median SYNTAX score of 27 (IQR 23–34). NLR and PLR did not differ significantly between patients with single-vessel and multivessel disease (p = 0.868 and p = 0.956, respectively). ROC curve analysis demonstrated poor discriminatory ability of NLR and PLR in predicting high SYNTAX scores, with areas under the curve of 0.542 and 0.533, respectively. In multivariable logistic regression analysis, increasing age (adjusted OR 1.06, 95% CI 1.01–1.11), elevated serum creatinine (adjusted OR 1.89, 95% CI 1.21–2.95), and higher troponin-I levels (adjusted OR 1.14, 95% CI 1.05–1.23) were independently associated with multivessel coronary artery disease.
Conclusion: NLR and PLR were not reliable predictors of multivessel coronary artery disease or high SYNTAX score in patients with STEMI. Conventional clinical and biochemical parameters, including age, serum creatinine, and troponin-I, demonstrated stronger predictive value.
