〔Abstract〕 Objective To investigate the predictive value of (Apo)B/A, low-density lipoprotein (LDL)/high-density lipoprotein (HDL) in acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 158 patients diagnosed with acute STEMI in the Affiliated Hospital of Putian University from January 2017 to December 2018 were selected as the observation group, and 121 patients with coronary heart disease without stent implantation were selected as the control group. The basic clinical data, laboratory indicators, color doppler echocardiography, coronary angiography and other data of the two groups were retrospectively analyzed to analyze the risk factors for STEMI and calculate the diagnostic efficacy of related risk factors. Results There were statistically significant differences in total cholesterol (TC), HDL, LDL, LDL/HDL and Apo B/A between the two groups (P < 0.05). Multivariate logistic regression analysis showed that Apo B/A and LDL/HDL were independent risk factors for STEMI (P < 0.05). Receiver operating characteristic curve (ROC) analysis showed that Apo B/A and LDL/HDL were higher efficiency in diagnosing STEMI. Conclusion LDL/HDL and Apo B/A are closely related to the occurrence of STEMI and can be used as predictors of STEMI.