Objective To explore the predictive value of the ratio of lipoprotein(a) Lp(a) to lymphocytes Lp(a)/LYM combined with the ratio of C-reactive protein (CRP) to high-density lipoprotein cholesterol (HDL-C) (CHR) for coronary heart disease and its severity.

Methods Patients who underwent coronary angiography were retrospectively selected as the study subjects. According to the inclusion and exclusion criteria, 291 cases were finally included in coronary heart disease group and 155 cases in non-coronary heart disease group. The clinical data of the two groups were compared, and the independent influencing factors of coronary heart disease were screened through univariate and multivariate logistic regression analysis. Based on the Gensini score, patients in the coronary heart disease group were divided into high, medium, and low Gensini score groups. The clinical data of the three groups were compared, and the correlations between Lp(a)/LYM, CHR, and the Gensini score were analyzed. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of Lp(a)/LYM and CHR for coronary heart disease and severe coronary artery lesions.

Results There were statistically significant differences between the coronary heart disease group and the non-coronary heart disease group in terms of gender, age, smoking history, diabetes, stroke, hypertension, neutrophil count, lymphocyte count, monocyte count, CRP, HDL-C, apolipoprotein A1, Lp(a), Lp(a)/LYM, and CHR (P < 0.05). Multivariate logistic regression analysis showed that age, smoking history, diabetes, hypertension, Lp(a)/LYM, and CHR were independent influencing factors for coronary heart disease (P < 0.05). The ROC curve showed that the areas under the curve (AUC) for Lp(a)/LYM and CHR in predicting coronary heart disease alone were 0.704 and 0.864, respectively, and the AUC for their combined prediction was 0.875, with a significantly higher predictive efficacy compared to individual prediction (P < 0.001). There were statistically significant differences among the three groups of coronary heart disease patients in terms of age, length of hospital stay, heart rate on admission, neutrophil count, lymphocyte count, CRP, HDL-C, Lp(a), Lp(a)/LYM, and CHR (P < 0.05). Spearman correlation analysis showed that Lp(a)/LYM and CHR in patients with coronary heart disease were positively correlated with the Gensini score (r=0.347, 0.389, P < 0.001). The ROC curve showed that the AUCs for Lp(a)/LYM and CHR in predicting severe coronary artery lesions alone were 0.706 and 0.712, respectively, and the AUC for their combined prediction was 0.779, with a significantly higher predictive efficacy compared to individual predictions (P < 0.001).

Conclusion Both Lp(a)/LYM and CHR are independent influencing factors for coronary heart disease, and their combination can better predict coronary heart disease and its severity.