{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:53:47Z","timestamp":1791262427698,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Anemia and renal impairment are key predictors of adverse outcomes in acute coronary syndromes (ACSs). The hemoglobin-to-creatinine (Hb\/Cr) ratio combines these parameters into a simple index. This study aimed to evaluate its prognostic value at discharge in patients with ST-elevation myocardial infarction (STEMI). Methods: The primary endpoint was one-year all-cause mortality; secondary endpoints included major bleeding and the composite of all-cause mortality or reinfarction. Optimal Hb\/Cr cut-off values were identified using Liu\u2019s method. Multivariable logistic regression and propensity score matching were used to assess associations with outcomes. Results: We analyzed 11,236 STEMI patients from the PRAISE registry with available hemoglobin and creatinine values at discharge. The optimal cut-points were 13.68 for mortality and 14.42 for secondary endpoints. Patients were stratified into low (&lt;13.68; 26.5%) and high (\u226513.68; 73.5%) Hb\/Cr groups. The low Hb\/Cr group was older, had more comorbidities, and received less intensive therapy. At one year, low Hb\/Cr patients had significantly higher rates of all-cause mortality (8.7% vs. 2.4%), major bleeding (5.0% vs. 2.4%), and the composite outcome (11.5% vs. 4.9%). In the multivariate logistic regression, the Hb\/Cr ratio was inversely associated with all outcomes, namely all-cause mortality (odds ratio [OR] 0.94; 95% confidence interval [CI]: 0.92\u20130.96), major bleeding (OR 0.96; 95% CI: 0.94\u20130.97), and the composite endpoint (OR 0.93; 95% CI: 0.91\u20130.96). The Hb\/Cr ratio outperformed hemoglobin and creatinine alone in predicting mortality (AUC 0.684 vs. 0.649 and 0.645; p &lt; 0.001). Conclusions: The Hb\/Cr ratio is independently associated with one-year adverse outcomes in STEMI and may serve as a simple marker of increased vulnerability. Prospective studies are needed to validate its clinical utility.<\/jats:p>","DOI":"10.3390\/jcm14082756","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T04:16:21Z","timestamp":1744863381000},"page":"2756","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hemoglobin-to-Creatinine Ratio Predicts One-Year Adverse Clinical Outcomes in ST-Elevation Myocardial Infarction: Retrospective and Propensity Score Matched Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-4121","authenticated-orcid":false,"given":"Luigi","family":"Spadafora","sequence":"first","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7504-3775","authenticated-orcid":false,"given":"Stefano","family":"Cacciatore","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics, and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy"},{"name":"Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-182X","authenticated-orcid":false,"given":"Mattia","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"},{"name":"Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Collet","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, 9300 Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8458-3747","authenticated-orcid":false,"given":"Matteo","family":"Betti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2571-2377","authenticated-orcid":false,"given":"Gianmarco","family":"Sarto","sequence":"additional","affiliation":[{"name":"ICOT Istituto Marco Pasquali, 04351 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9223-8587","authenticated-orcid":false,"given":"Beatrice","family":"Simeone","sequence":"additional","affiliation":[{"name":"ICOT Istituto Marco Pasquali, 04351 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-1757","authenticated-orcid":false,"given":"Erica","family":"Rocco","sequence":"additional","affiliation":[{"name":"ICOT Istituto Marco Pasquali, 04351 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"D\u2019Ascenzo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4940-0876","authenticated-orcid":false,"given":"Gaetano Maria","family":"De Ferrari","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidio","family":"De Filippo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, Citt\u00e0 della Salute e della Scienza Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-3673","authenticated-orcid":false,"given":"Pierre","family":"Sabouret","sequence":"additional","affiliation":[{"name":"Heart Institute and Action Group, Piti\u00e9-Salp\u00e9tri\u00e8re, Sorbonne University, 75013 Paris, France"},{"name":"National College of French Cardiologists, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9989-198X","authenticated-orcid":false,"given":"Iginio","family":"Colaiori","sequence":"additional","affiliation":[{"name":"UOC UTIC Emodinamica e Cardiologia, Ospedale Santa Maria Goretti, 04351 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-9595","authenticated-orcid":false,"given":"Roberto","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"},{"name":"IRCCS NeuroMed, 86030 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-9648","authenticated-orcid":false,"given":"Valentina","family":"Valenti","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"},{"name":"Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Gaudio","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0975-3815","authenticated-orcid":false,"given":"Francesca Romana","family":"Zimatore","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases Residency Program, Azienda 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Latina, Italy"},{"name":"IRCCS NeuroMed, 86030 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6103-8510","authenticated-orcid":false,"given":"Giuseppe","family":"Biondi Zoccai","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"},{"name":"Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9269-8829","authenticated-orcid":false,"given":"Marco","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. 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