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A positive correlation was found between MHR and infarct size in the groups with and without AR. High MHR was an independent predictor of AR (OR 3.21, p = 0.002). The cut-off value of MHR in predicting AR was found to be 1.6 with 92.7% sensitivity and 70.1% specificity (AUC ± SE 0.839 ± 0.03, p 0.001). Mortality risk was 5.62-fold higher in the group with MHR of 1.6 (HR 5.62, p 0.001). These results indicate that admission MHR is a useful tool to predict patients with AR who are at risk of progression to heart failure and