Analysis of the Relationship between Serum NT-ProBNP, NLR, hs-CRP/PA Ratio and Coronary Artery Lesions and Prognosis in Patients with Coronary Heart Disease

doi:10.3969/j.issn.1674-3245.2025.04.031

Abstract：Objective To analyze the relationship between serum N-terminal pro-B-type natriuretic peptide (NT-ProBNP), neutrophil-to-lymphocyte ratio (NLR), and high-sensitivity C-reactive protein (hs-CRP)/prealbumin (PA) ratio with coronary artery lesions and prognosis in patients with coronary heart disease (CHD). Methods A total of 80 CHD patients admitted to Wuhu County People's Hospital from June 2021 to June 2024 were retrospectively selected as the observation group. According to the severity of coronary artery lesions, they were divided into mild lesion group (33 cases), moderate lesion group (25 cases), and severe lesion group (22 cases). According to whether major adverse cardiovascular events (MACE) occurred within 6 months after discharge, they were further divided into poor prognosis group (20 cases) and good prognosis group (60 cases). Another 60 healthy individuals who underwent physical examination during the same period were selected as the healthy control group. The levels of serum NT-ProBNP, NLR, and hs-CRP/PA were compared among groups. Spearman correlation analysis was used to evaluate the relationship between these indicators and the severity of coronary artery lesions. Multivariate logistic regression analysis was performed to identify factors affecting the prognosis of CHD. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of serum NT-ProBNP, NLR, and hs-CRP/PA for prognosis. Results The serum levels of NT-ProBNP, NLR, and hs-CRP/PA in the observation group were (673.86±30.95) pg/ml, (3.06±0.61), and (0.015±0.003), respectively, which were higher than those in the healthy control group [(84.26±10.98) pg/ml, (1.80±0.22), (0.004±0.001)], with statistically significant differences (t=140.952, 15.261, 27.267, P<0.05). In the severe lesion group, the serum levels of NT-ProBNP, NLR, and hs-CRP/PA were (746.33±44.41) pg/ml, (3.26±0.92), and (0.021±0.005), respectively; in the moderate lesion group, they were (610.08±30.26) pg/ml, (2.88±0.60), and (0.015±0.004); and in the mild lesion group, they were (436.99±22.50) pg/ml, (2.13±0.41), and (0.010±0.002). There were statistically significant differences in the levels of NT-ProBNP, NLR, and hs-CRP/PA among the three groups (F=631.236, 22.259, 59.528, P<0.05). Spearman correlation analysis showed that NT-ProBNP, NLR, and hs-CRP/PA were positively correlated with the severity of coronary artery lesions (r=0.936, 0.583, 0.765, P<0.05). The serum levels of NT-ProBNP, NLR, and hs-CRP/PA in the poor prognosis group were (722.65±38.40) pg/ml, (3.44±0.75), and (0.017±0.004), respectively, which were higher than those in the good prognosis group [(657.60±28.47) pg/ml, (2.93±0.50), (0.014±0.04)], with statistically significant differences (t=8.080, 3.459, 2.905, P<0.05). Multivariate logistic regression analysis showed that NT-ProBNP, NLR, and hs-CRP/PA were risk factors for the prognosis of CHD (P<0.05). ROC curve analysis showed that the combined detection of serum NT-ProBNP, NLR, and hs-CRP/PA had a sensitivity of 95.00% for predicting the prognosis of CHD patients, with an AUC of 0.947, which was higher than that of individual detection (Z=2.686, 3.375, 2.707, P<0.05). Conclusion The serum levels of NT-ProBNP, NLR, and hs-CRP/PA are elevated in patients with CHD and are related to the severity of coronary artery lesions and prognosis. The combined detection of these indicators has certain predictive value for patient prognosis.