Association of Neutrophil-to-Lymphocyte Ratio and Monocyte-to-Lymphocyte Ratio with Troponin I Levels in Patients with Acute Myocardial Infarction

Abstract

Acute myocardial infarction (AMI) is a manifestation of acute coronary syndrome associated with high morbidity and mortality. Inflammation plays a crucial role in AMI pathogenesis and is associated with the extent of myocardial injury. This study aimed to analyze the association between the Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Troponin I levels in patients with AMI at Advent Hospital Bandar Lampung. This retrospective analytical observational study included medical records of 104 patients with AMI from January 2024 to December 2025. Associations were analyzed using Spearman’s correlation test. Most patients were male (70.2%) and aged ≥65 years (51.0%). Elevated NLR was observed in 73 patients (70.2%), while elevated MLR was found in 55 patients (52.9%). NLR, MLR, and Troponin I levels were significantly higher in patients with ST-Elevation Myocardial Infarction (STEMI) than in those with Non-ST-Elevation Myocardial Infarction (NSTEMI) (p<0.05). Significant positive correlations were found between NLR and Troponin I levels (r=0.849; p<0.001) and between MLR and Troponin I levels (r=0.705; p<0.001). In conclusion, both NLR and MLR were positively correlated with Troponin I levels, with NLR demonstrating a stronger correlation. These parameters may serve as simple and cost-effective adjunctive inflammatory biomarkers for the clinical evaluation of patients with AMI.