摘要BACKGROUND The association between uric acid-albumin ratio(UAR)with different diseases has been evaluated before.How-ever,the association between UAR with spontaneous reperfusion(SR)in patients with ST-segment elevation myocardial infarcti-on(STEMI)has not been explored.METHODS STEMI patients admitted to our department and underwent primary coronary angiography between 1st Novemb-er 2018 and 31st December 2020 were retrospectively enrolled.The patients were divided into the SR group and the non-SR group according to the index coronary angiography results.The association between UAR and SR was evaluated by uni-variable and mu-lti-variable logistic analysis.Receiver operating characteristic curve analysis was used to determine the optimum cut-off level of UAR in predicting SR.RESULTS Three hundred and fifty-seven patients were finally enrolled in our study,55 patients were divided into the SR gro-up and 302 patients were divided into the non-SR group.In uni-variable analysis,patients with SR were older(P=0.032),with hi-gher red blood cell distribution width(P＜0.001)and red blood cell distribution width-to-platelet ratio(P＜0.001),higher level of C-reactive protein(P=0.046),higher level of uric acid(P＜0.001)compared with patients without SR.Patients with SR had a low-er level of platelets(P=0.008),lower level of on-admission B-type natriuretic peptide(P＜0.001).As for the level of UAR,STEMI patients with SR had significantly higher levels of UAR compared with STEMI patients without SR[11.1(8.9-13.4)vs.8.3(6.6-10.0),P＜0.001].Further multi-variable logistic analysis reveals that UAR was the independent risk factor of SR in different models after adjusting different variables.Receiver operating characteristic analysis showed that UAR had good predictive value in SR(AUC=0.75,95％CI:0.702-0.794,P＜0.01).CONCLUSIONS Our study shows that UAR is an independent risk factor for predicting SR in STEMI patients.