The HALP score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Abstract

Introduction and objective: Despite recent advances in the management of ST-segment elevation myocardial infarction (STEMI), the clinical outcome of some patients is still unsatisfactory. Therefore, early evaluation to identify high-risk individuals in STEMI patients is essential. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, as a new indicator that can reflect both nutritional status and inflammatory state of the body, can provide prognostic information. In this context, the present study was designed to investigate the relationship between HALP scores assessed at admission and no-reflow as well as long-term outcomes in patients with STEMI.

Material and methods: A total of 1040 consecutive STEMI patients undergoing primary PCI were enrolled in this retrospective study. According to the best cutoff value of HALP score of 40.11, the study samples were divided into two groups. The long-term prognosis was followed up by telephone.

Results: Long-term mortality was significantly higher in patients with HALP scores lower than 40.11 than in those higher than 40.11. The optimal cutoff value of HALP score for predicting no-reflow was 41.38, the area under the curve (AUC) was 0.727. The best cutoff value of HALP score for predicting major adverse cardiovascular events (MACE) was 40.11, the AUC was 0.763. The incidence of MACE and all-cause mortality was higher in the HALP score <40.11 group.

Conclusion: HALP score can independently predict the development of no-reflow and long-term mortality in STEMI patients undergoing PCI.

Keywords: HALP score; ST-segment elevation myocardial infarction; long-term mortality; no-reflow phenomenon.

Fig. 1

Flowchart of this study. The figure shows the selection and exclusion criteria and follow-up of the study subjects.

Fig. 2

The Kaplan–Meier curves of the cumulative incidence of (a) MACE, (b) worsening heart failure, (c) repeated revascularization procedures after PCI, and (d) cardiovascular mortality. MACE, major adverse cardiac events; PCI, percutaneous coronary intervention.

Fig. 3

The ROC curve was used to evaluate the HALP score for predicting (a) long-term MACE and (b) no-reflow phenomenon. HALP score, the hemoglobin, albumin, lymphocyte, and platelet score; ROC, receiver operating characteristic.