Background: The present study aimed to investigate whether newly defined serum uric acid (SUA) to serum creatinine ratio (SUA/SCr) predicts no-reflow phenomenon (NRP) development in patients with non-ST-elevated acute coronary syndrome (NSTE-ACS).

Methods: The study group was divided into two groups: those who developed NRP and those who did not. Complete blood counts, SUA, serum creatinine, C-reactive protein (CRP) and albumin were obtained at admission. The SUA/SCr, SUA to albumin ratio (UAR), C-reactive protein to albumin ratio (CAR) and systemic immune inflammation (SII) index values of all patients were calculated and their relationships with NRP were evaluated.

Results: Patients with NRP had higher mean SUA/SCr ratio (7.19 ± 2.14 vs 5.30 ± 1.70,  < 0.001), mean UAR (1.73 ± 0.69 vs 1.38 ± 0.47,  < 0.001), median CAR (1.73 vs 1.54,  = 0.002), and median SII index (861.9 vs 730.9,  = 0.015) levels than in those who did not develop NRP. According to multivariant analysis models, SUA/SCr ratio, UAR, CAR and SII index were found to be independent predictors of NRP development ( < 0.05 for all) but only the area under the curve (AUC) for SUA/SCr ratio (AUC = 0.73,  < 0.001) was above the 0.70 proficiency level, performing markedly better than the other evaluated parameters. A SUA/SCr ratio ≥5.34 predicted the NRP with 75% sensitivity and 55% specificity.

Conclusion: SUA/SCr ratio can be used as a reliable marker in prediction the development of NRP in NSTE-ACS patients.

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http://dx.doi.org/10.1080/00015385.2025.2452101DOI Listing

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