Association of Monocyte/HDL and Neutrophil/Lymphocyte Ratios with SYNTAX II Scores in Emergency Department STEMI Patients
DOI:
https://doi.org/10.58600/eurjther3033Keywords:
acute coronary syndrome, emergency department, Monocyte/High-Density Lipoprotein Ratio (MHR), Neutrophil/Lymphocyte Ratio (NLR), Syntax scoreAbstract
Objective: Coronary artery disease (CAD) is a leading cause of morbidity and mortality and may present as ST-segment elevation myocardial infarction (STEMI) in emergency departments. This study aimed to evaluate the relationship between inflammation and oxidative stress markers-monocyte/High-Density Lipoprotein Ratio (MHR) and Neutrophil/Lymphocyte Ratio (NLR) and the SYNTAX II score, a validated indicator of CAD complexity and prognosis in STEMI patients.
Methods: Our study was conducted retrospectively as a cross-sectional study including 342 patients aged 18 years and older who were diagnosed with ST-elevation myocardial infarction (STEMI) based on electrocardiographic findings and underwent angiography at the Emergency Medicine Clinic of Ankara Bilkent City Hospital between July 1, 2022, and July 1, 2023, either via the 112 ambulance system or as outpatients. Laboratory test results obtained within the first 24 hours after admission and before angiography were used. Angiography images were obtained from the Hospital Information Management System and interpreted by cardiologists. The Syntax score was calculated by cardiologists using an online calculator, and the data was recorded. The Syntax II score was calculated by us using an online calculator by adding the Syntax score and additional patient-related parameters.
Results: Of the cohort, 83.3% (n=285) were male, with a mean age of 57.16 years. Elevated SYNTAX II scores were significantly associated with age (p<0.001), smoking (p=0.011), diabetes (p=0.014), hypertension (p<0.001), COPD (p<0.001), and cerebrovascular disease (p=0.015). Higher scores also correlated with increased 30-day mortality (p=0.007). NLR values demonstrated a significant positive correlation with SYNTAX II scores (p=0.035). MHR was associated with recurrent emergency admissions within six months (p=0.048) but not directly with SYNTAX II.
Conclusion: NLR may be a cost-effective and straightforward marker for assessing CAD complexity in STEMI patients in emergency settings. However, the prognostic role of MHR remains inconclusive and warrants further prospective validation.
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Copyright (c) 2026 Fulya Keskin Elmas, Hakan Oğuztürk, Habibe Selmin Özensoy, Safa Dönmez, Gülhan Kurtoğlu Çelik, Atik Aksoy, Ömer Faruk Tamer
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