Ji Weibiao, Chen Yangbo, Zhou Haoyue, Huang Weipeng, Xu Shangbo
Department of Cardiology, Jieyang People's Hospital, Jieyang, 522000, Guangdong, China.
BMC Cardiovasc Disord. 2025 May 24;25(1):394. doi: 10.1186/s12872-025-04856-9.
The long-term relationship between hemoglobin to serum creatinine (HB/SCr) ratio and clinical outcomes in ST-elevation myocardial infarction (STEMI) remains uncertain. This study aimed to determine the predictive value of the HB/SCr ratio for long-term major adverse cardiovascular events (MACE) in patients with STEMI.
This study was based on a prospective cohort conducted in China, which included 460 STEMI patients who successfully underwent primary percutaneous coronary intervention. Cox proportional hazards models were utilized to explore the relationship between the HB/SCr ratio and MACE in STEMI patients over a 30-month follow-up period. The predictive value of the HB/SCr ratio for MACE was assessed using the receiver operating characteristic curve.
A total of 118 patients (26%) developed MACE during the follow-up period. After adjusting for confounding factors, a lower HB/SCr ratio emerged as a significant predictor of MACE in STEMI patients. Subgroup analyses indicated that the HB/SCr ratio was inversely associated with MACE in patients aged ≥ 60 years, males, those with a history of hypertension, individuals experiencing anterior wall myocardial infarction, patients classified as Killip grade I, and those receiving single stent implantation. Sensitivity analysis revealed that the inverse association between the HB/SCr ratio and MACE occurrence persisted in patients with normal hemoglobin levels. The area under the curve for the HB/SCr ratio in predicting MACE was 0.611.
The baseline HB/SCr ratio was inversely associated with MACE, suggesting that it may serve as a useful biomarker for identifying high-risk STEMI patients at an early stage.
血红蛋白与血清肌酐（HB/SCr）比值与ST段抬高型心肌梗死（STEMI）临床结局的长期关系尚不确定。本研究旨在确定HB/SCr比值对STEMI患者长期主要不良心血管事件（MACE）的预测价值。
本研究基于在中国进行的一项前瞻性队列研究，纳入了460例成功接受直接经皮冠状动脉介入治疗的STEMI患者。采用Cox比例风险模型探讨HB/SCr比值与STEMI患者在30个月随访期内MACE的关系。使用受试者工作特征曲线评估HB/SCr比值对MACE的预测价值。
共有118例患者（26%）在随访期间发生MACE。在调整混杂因素后，较低的HB/SCr比值成为STEMI患者MACE的显著预测因素。亚组分析表明，HB/SCr比值与年龄≥60岁的患者、男性、有高血压病史的患者、发生前壁心肌梗死的患者、Killip分级为I级的患者以及接受单支架植入的患者的MACE呈负相关。敏感性分析显示，在血红蛋白水平正常的患者中，HB/SCr比值与MACE发生之间的负相关仍然存在。HB/SCr比值预测MACE的曲线下面积为0.611。
基线HB/SCr比值与MACE呈负相关，表明它可能是早期识别高危STEMI患者的有用生物标志物。
