The potential of platelet to high-density lipoprotein cholesterol ratio (PHR) as a novel biomarker for heart failure

Abstract Heart failure (HF) is closely linked to platelet counts and lipid levels. The platelet-to-high-density lipoprotein cholesterol ratio (PHR) is a novel marker for assessing cardiovascular disease. This study investigates the relationship between PHR and HF. We analyzed data from ten consecutive NHANES survey cycles (1998–2018), focusing on self-reported HF diagnoses with complete PHR information. PHR was calculated as platelet count divided by HDL-C (mmol/L). A multivariate logistic regression model was used to examine the association between PHR and HF, with subgroup analyses to identify potential influencing factors. RCS curve plotting and threshold effect analysis were employed to describe non-linear relationships. The study included 31,410 adults aged 20–85 years. The multivariate logistic regression indicated that individuals with the highest PHR had 82% increased likelihood of HF compared to those with the lowest PHR (OR = 1.82; 95% CI, 1.37–2.40, P 0.05), except in those with alcohol consumption (yes/no) and BMI subgroups (P