Cardiovascular Journal of Africa

Association between serum uric acid-to-high-density lipoprotein cholesterol ratio and myocardial bridging: a cross-sectional study

Emirhan Hancıoğlu, Sevgi Özcan, Özkan Bekler, Asım Enhoş, Ertuğrul Okuyan
Abstract
Background: Myocardial bridging (MB) is a congenital coronary anomaly that is often regarded as a benign condition but may lead to adverse clinical outcomes. Systemic metabolic and inflammatory markers have been suggested as potential indicators of MB.
Objective: To investigate the association between the uric acid-to-high-density lipoprotein cholesterol ratio (UHR) and the presence of MB.
Methods: In this retrospective study, patients who underwent elective coronary angiography were evaluated. A total of 245 patients meeting the inclusion criteria were included. Based on angiographic findings, patients were classified into two groups: those with MB (MB[+]) and a control group with normal coronary arteries. Serum UHR, neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-HDL cholesterol ratio (MHR) were calculated. Univariate and multivariate logistic regression analyses were performed to determine independent predictors of MB. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of inflammatory indices.
Results: Among the 245 patients included in the study, 129 (52.6%) had MB. In multivariate analysis, NLR (odds ratio [OR] = 2.858, 95% confidence interval [CI]: 1.750–4.668, p = 0.001), MHR (OR = 1.126, 95% CI: 1.021–1.242, p = 0.018), and UHR (OR = 1.342, 95% CI: 1.161–1.552, p = 0.001) were independent predictors of MB. ROC analysis demonstrated that UHR had the highest discriminative ability for MB (AUC = 0.853, 95% CI: 0.803–0.902, p < 0.001), with an optimal cut-off value of 9.9, yielding 81.4% sensitivity and 80.3% specificity.
Conclusion: UHR is an independent predictor of MB and may serve as a useful biomarker for guiding clinical management.
Keywords: atherosclerosis, inflammation, myocardial bridge, UHR
Submitted: November 28, 2025; Accepted: February 11, 2026; Published: July 6, 2026
Cardiovasc J Afr 2025; 37: 264-268
Volume 37, Issue 3
DOI Citation Reference: dx.doi.org/10.5830/CVJA-2026-012
Department of Cardiology, Istanbul Medipol University, Acıbadem District Hospital, Kadıköy, Istanbul
Emirhan Hancıoğlu
Özkan Bekler
Asım Enhoş
Ertuğrul Okuyan

Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar, Istanbul
Sevgi Özcan

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