Abstract
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.