Objective ·To investigate the correlations of the neutrophil percentage-to-albumin ratio (NPAR), monocyte-to-high-density lipoprotein ratio (MHR), fibrosis-4 index (FIB-4), and lipoprotein(a) [LP(a)] levels with the synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score in patients with coronary heart disease. Methods ·A total of 289 patients with coronary heart disease hospitalized in the Department of Cardiovascular Medicine at Friendship Hospital, Ili Kazakh Autonomous Prefecture, from January 2023 to January 2025 and diagnosed by coronary angiography were enrolled. According to the SYNTAX score, patients were divided into a low-risk group (n=122), an intermediate-risk group (n=86), and a high-risk group (n=81). Baseline characteristics and laboratory data were collected, including age, history of hypertension, body mass index (BMI), gender, history of diabetes, smoking history, drinking habits, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, LP(a), creatinine, and uric acid. Multivariate Logistic regression analysis was performed to evaluate the associations between the above factors and the SYNTAX score. Moreover, receiver operating characteristic (ROC) curve analysis was used to assess the predictive accuracy of NPAR, MHR, FIB-4, and LP(a) for the SYNTAX score. Results ·No statistically significant differences were observed among the three groups in gender, age, BMI, history of hypertension, smoking history, blood lipids, creatinine, uric acid, or other baseline data (all P>0.05). However, the prevalence of diabetes and the levels of high-density lipoprotein cholesterol, LP(a), and NPAR differed significantly among the three groups (all P<0.05). After pooling the intermediate-risk and high-risk groups into an intermediate-high-risk group (n=167), comparison with the low-risk group (n=122) revealed a significantly higher prevalence of diabetes and elevated LP(a) and NPAR levels (all P<0.05). Multivariate Logistic regression analysis revealed that diabetes (OR=1.768, 95%CI 1.024‒3.051, P=0.041), NPAR (OR=5.386, 95%CI 2.216‒13.089, P<0.001), and LP(a) (OR=1.002, 95%CI 1.000‒1.003, P=0.043) were independent factors associated with high-risk coronary artery lesions. ROC curve analysis showed that the area under the curve (AUC) of NPAR was 0.641 (95%CI 0.576‒0.705, P<0.001), and that of LP(a) was 0.572 (95%CI 0.505‒0.639, P=0.038). The combined AUC of NPAR and LP(a) was 0.665 (95%CI 0.602‒0.728, P<0.001), which demonstrated superior predictive efficacy compared with either marker alone, whereas MHR (AUC=0.530, P=0.390) and FIB-4 (AUC=0.525, P=0.478) showed no statistically significant predictive value. Conclusion ·Both NPAR and LP(a) levels were positively associated with the SYNTAX score, suggesting their potential utility as reference markers for assessing the severity of coronary artery disease.
