Objective: To observe the effect of dual antiplatelet therapy with aspirin and ticagrelor on neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), in patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: Using a random number table, 120 patients with coronary heart disease who underwent PCI in the hospital from May 2024 to February 2025 were assigned to the control group and the observation group, with 60 cases in each group. Clinical efficacy, NLR, PLR were compared between the two groups. Adverse events in the two groups were statistically analyzed. Results: The clinical efficacy of the observation group was higher than that of the control group (P < 0.05). NLR, PLR were comparable between the two groups before treatment (P>0.05). Compared with the control group after treatment, the observation group showed reductions in NLR, PLR levels (P<0.05). Bleeding time and incidence rates of gastrointestinal reactions and MACE in the two groups were similar (P>0.05). Conclusion: The dual antiplatelet therapy with aspirin and ticagrelor can reduce NLR and PLR and improves outcomes in patients with coronary heart disease after PCI.