BACKGROUND: We aimed to evaluate the value of lipoprotein-associated phospholipase A2 (Lp-PLA2) in the serum plus leukocyte-derived markers such as platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) for predicting heart failure (HF) after acute myocardial infarction (AMI). METHODS: A total of 80 AMI patients (case group) hospitalized between June 2019 and July 2022 and 80 healthy subjects (healthy group) were selected. An HF group and a non-HF group were established for the case group. The general data, serum Lp-PLA2 concentration, PLR, and NLR were compared between the two subgroups. Analysis of the risk factors for HF in AMI patients was performed. RESULTS: The case group, compared with the healthy group, had higher serum Lp-PLA2 concentration, PLR, and NLR (p <
0.05). HF occurred in 10 cases (12.50%) in the case group. In comparison to the non-HF group, increases of serum Lp-PLA2 concentration, PLR, and NLR were detected in the HF group (p <
0.05). Elevated se-rum Lp-PLA2 concentration, PLR, and NLR served as risk factors for HF in AMI patients (OR >
1, p <
0.05). NLR, PLR, serum Lp-PLA2, and combination of the three had the areas under the curves of 0.734, 0.731, 0.719, and 0.910, respectively, in predicting HF in AMI patients. CONCLUSIONS: NLR, PLR, and serum Lp-PLA2 concentration were elevated in AMI patients, that were associated with HF. Combined determination of NLR, PLR, and serum Lp-PLA2 can effectively predict the risk of HF in AMI patients.