Background: The new inflammatory measure, the red cell distribution ratio platelet width (RPR), is now utilised to predict inflammation in chronic illnesses. It may be linked with unfavourable effects among coronary artery disease, although its predictive value in the ST segment of myocardial elevation (STEMI) has not been well studied. There are no data concerning the relationship between RPR and major cardiovascular events in hospitals (MACEs). This research examined the relationships between preoperative RPR and no reflow and hospital results in primary PCI STEMI patients. Methods: 100 STEMI patients were included in this research (66% males; average age: 55 ± 11 years). The patients were split into two groups based on myocardial infarction thrombolysis (TIMI) in the flow rates after initial PCI. No-reflow was defined as a flow rate of 0, 1 or 2 after PCI TIMI (group 1). Angiographical success has been described as the flow grade 3 of TIMI (group 2). Results: The proportion of neutrophil and lymphocyte, red cell spread, neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR) and RPR was greater in patients without reflow. With multivariate analyses, ballon pain times, TIMI thrombus gradation, tirofiban, NLR, PLR and RPR, the non-reflow predictors after initial PCI remain independent. In the non-reflow group, patients in the MACE hospital tended to have greater percentages than in patients in reflows, including non-fatal myocardial infarctions and cardiovascular mortality. Conclusions: NLR, PLR and RPR admission are independent non-reflow correlations between primary PCI STEMI patients.