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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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The complex inflammatory indexes predict the prognostic risk for patients with acute coronary syndrome undergoing

Ge Song1, Yan Liu1, Ying Zhang1,2

  • 1Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, 067000, China.

BMC Immunology
|September 1, 2025
PubMed

Insights

High neutrophil-to-lymphocyte-platelet ratio (NLPR) and neutrophil-lymphocyte ratio (NLR), especially when combined with cholesterol levels, are significant predictors of major adverse cardiovascular events (MACEs) in acute coronary syndrome (ACS) patients post-PCI. These markers indicate poorer long-term prognosis.

Area of Science:

  • Cardiology
  • Biomarkers
  • Prognostic risk assessment

Background:

  • Accurate prognostic risk assessment is crucial for improving survival in acute coronary syndrome (ACS) patients.
  • Investigating novel biomarkers can enhance risk stratification in ACS management.

Purpose of the Study:

  • To evaluate the prognostic roles of neutrophil-to-lymphocyte-platelet ratio (NLPR) and neutrophil-lymphocyte ratio (NLR) in predicting major adverse cardiovascular events (MACEs).
  • To assess the combined predictive value of NLPR and NLR with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels in ACS patients undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • Retrospective analysis of 1,263 ACS patients undergoing PCI (January 2016 - December 2018).
  • Patients categorized into MACEs (n=54) and non-MACEs (n=1,209) groups.
  • MACEs defined as cardiac mortality, re-hospitalization for heart failure, myocardial infarction, or in-stent restenosis.

Main Results:

  • Kaplan-Meier analysis indicated higher cumulative survival in patients with low NLPR and NLR.
  • Elevated NLPR/HDL-C, NLPR×LDL-C, NLR/HDL-C, and NLR×LDL-C ratios were associated with significantly lower cumulative survival.
  • Specific thresholds for NLPR, NLR, and their combinations with lipid levels were identified as independent risk factors.

Conclusions:

  • NLPR and NLR, particularly when combined with HDL-C and LDL-C levels, are independent prognostic risk factors in ACS patients post-PCI.
  • These ratios (NLPR ≥ 2.843, NLPR/HDL-C ≥ 1.977, NLPR×LDL-C ≥ 4.608, NLR ≥ 0.025, NLR/HDL-C ≥ 0.030, NLR×LDL-C ≥ 0.038) serve as valuable markers for long-term prognosis.
  • These findings may aid in refining risk stratification and guiding therapeutic strategies for ACS patients.
Abstract

Keywords:
Acute coronary syndromeNeutrophil-lymphocyte ratioNeutrophil-to-lymphocyte * platelet ratioPercutaneous coronary interventionPrognosis

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