The platelet-to-high-density-lipoprotein-cholesterol ratio: a promising biomarker for predicting major adverse cardiovascular events in the Chinese community-based population
- 1Department of Cardiology, Peking University First Hospital
- 2Institute of Cardiovascular Disease, Peking University First hospital
Abstract
Background: The platelet-to-high-density-lipoprotein-cholesterol ratio (PHR), a composite index integrating platelet count and HDL-C concentration, has recently attracted attention as a potential indicator of inflammatory and metabolic status. However, evidence regarding its relationship with major adverse cardiovascular events (MACE) is still limited. Therefore, using data from a prospective community-based cohort, we evaluated whether baseline PHR was associated with the occurrence of MACE during 10 years of follow-up.
Methods: A total of 8,184 eligible subjects were included in our analysis. The primary outcome was MACE, and the secondary outcome was acute myocardial infarction (AMI), stroke, and CV mortality over 10 years. The PHR was calculated as the ratio of platelets to high-density-lipoprotein-cholesterol (HDL-C). Associations between baseline PHR and subsequent MACE were examined using multivariable Cox proportional hazards models, with effect estimates reported as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).
Results: Of all participants, the mean age was 56.4 ± 8.9 years, and 2,989 (36.5%) were men. During a mean 10-year follow-up, a total of 853 (10.4%) cases of MACE, 165 (2.0%) cases of AMI, 673 (8.2%) cases of stroke, and 143 (1.7%) cases of CV mortality were recorded. After multivariable adjustment, individuals in the highest PHR quartile showed a greater risk of MACE than those in the lowest quartile (HR: 1.37; 95% CI: 1.12–1.69). A similar association was observed for AMI, with the highest quartile having more than twice the risk of the lowest quartile (HR: 2.44; 95% CI: 1.43–4.18). In contrast, the corresponding associations with stroke (HR: 1.27; 95% CI: 1.00–1.60) and CV mortality (HR: 1.07; 95% CI: 0.65–1.77) were not statistically significant.
Conclusions: These findings indicate that higher PHR is associated with an increased long-term risk of MACE and AMI among Chinese community-dwelling adults, suggesting that PHR may serve as a potential biomarker associated with cardiovascular risk.
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BibTeX
@article{dong2026platelettohighdensitylipoproteincholesterol,
title = {{The platelet-to-high-density-lipoprotein-cholesterol ratio: a promising biomarker for predicting major adverse cardiovascular events in the Chinese community-based population}},
author = {Lei Dong and Long Zhang and Fangfang Fan and Yan Zhang and Jianping Li},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1868836},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1868836/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The platelet-to-high-density-lipoprotein-cholesterol ratio: a promising biomarker for predicting major adverse cardiovascular events in the Chinese community-based population
AU - Lei Dong
AU - Long Zhang
AU - Fangfang Fan
AU - Yan Zhang
AU - Jianping Li
PY - 2026
DA - 2026/10/14
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1868836
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1868836/full
AB - Background: The platelet-to-high-density-lipoprotein-cholesterol ratio (PHR), a composite index integrating platelet count and HDL-C concentration, has recently attracted attention as a potential indicator of inflammatory and metabolic status. However, evidence regarding its relationship with major adverse cardiovascular events (MACE) is still limited. Therefore, using data from a prospective community-based cohort, we evaluated whether baseline PHR was associated with the occurrence of MACE during 10 years of follow-up. Methods: A total of 8,184 eligible subjects were included in our analysis. The primary outcome was MACE, and the secondary outcome was acute myocardial infarction (AMI), stroke, and CV mortality over 10 years. The PHR was calculated as the ratio of platelets to high-density-lipoprotein-cholesterol (HDL-C). Associations between baseline PHR and subsequent MACE were examined using multivariable Cox proportional hazards models, with effect estimates reported as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: Of all participants, the mean age was 56.4 ± 8.9 years, and 2,989 (36.5%) were men. During a mean 10-year follow-up, a total of 853 (10.4%) cases of MACE, 165 (2.0%) cases of AMI, 673 (8.2%) cases of stroke, and 143 (1.7%) cases of CV mortality were recorded. After multivariable adjustment, individuals in the highest PHR quartile showed a greater risk of MACE than those in the lowest quartile (HR: 1.37; 95% CI: 1.12–1.69). A similar association was observed for AMI, with the highest quartile having more than twice the risk of the lowest quartile (HR: 2.44; 95% CI: 1.43–4.18). In contrast, the corresponding associations with stroke (HR: 1.27; 95% CI: 1.00–1.60) and CV mortality (HR: 1.07; 95% CI: 0.65–1.77) were not statistically significant. Conclusions: These findings indicate that higher PHR is associated with an increased long-term risk of MACE and AMI among Chinese community-dwelling adults, suggesting that PHR may serve as a potential biomarker associated with cardiovascular risk.
SN - 2297-055X
ER -