Predictive value of fecal sulfatide and neutrophil-to‑lymphocyte ratio in coronary heart disease.

The incidence of coronary atherosclerotic heart disease is on the rise, posing a serious threat to public health. Emerging evidence highlights the interplay between systemic inflammation and cardiovascular pathophysiology, suggesting novel diagnostic avenues. The aim of the present study was to evaluate the predictive value of fecal sulfatide and neutrophil-to-lymphocyte ratio (NLR), both individually and in combination, for coronary heart disease (CHD). A total of 523 patients diagnosed with CHD at the Cardiovascular Department of Hebei General Hospital (Shijiazhuang, China) from August 2022 to September 2023 were included in the experimental group, along with 198 healthy controls. The CHD group was further subdivided into stable angina pectoris (n=194), unstable angina pectoris (n=134), and acute myocardial infarction (AMI) groups (n=195). Fecal sulfatide and serum NLR levels were measured in both the experimental and control groups, as well as within each CHD subgroup. Multivariate logistic regression was utilized to assess whether these biomarkers serve as independent risk factors for CHD. The predictive value of fecal sulfatide and serum NLR was evaluated using receiver operating characteristic curves. Fecal sulfatide and serum NLR levels were distinctly higher in the CHD group compared with the control group (2.40±0.48 vs. 1.64±0.39 µmol/l and 2.92 vs. 1.65; P<0.05). Patients with AMI had higher NLR levels than those with stable and unstable angina pectoris (5.55 vs. 2.65 and 2.68; P<0.05). Fecal sulfatide levels were also elevated in patients with AMI (2.50±0.44 µmol/l) compared with patients with stable angina pectoris (2.32±0.48 µmol/l). Both fecal sulfatide (AUC=0.899) and NLR (AUC=0.811) exhibited strong predictive accuracy for CHD. When combined, the predictive value (AUC=0.945) was further improved. Elevated levels of fecal sulfatide and serum NLR in patients with CHD revealed that these biomarkers may serve as valuable adjuncts in the diagnosis of CHD. The combined use of these biomarkers enhances the accuracy and reliability of CHD prediction.