The predictive value of the HALP score for no-reflow phenomenon and short-term mortality in patients with ST-elevation myocardial infarction

ABSTRACT

Objective

ST-elevation myocardial infarction (STEMI) is a medical emergency demanding immediate intervention, and primary percutaneous coronary intervention (pPCI) is the standard of care for this condition. While PCI has proven highly effective, a subset of patients experience the devastating no-reflow phenomenon, and some face increased short-term mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, a novel biomarker-based tool, has recently surfaced as an innovative predictor of these adverse outcomes. This study aims to investigate the groundbreaking findings that designate a low HALP score as a robust risk factor for no-reflow and short-term mortality in STEMI patients.

Methods

1817 consecutive STEMI patients who underwent pPCI were included in this retrospective study, and the patients were divided into two groups according to whether no-reflow developed or not, and the HALP scores of the groups were compared. In addition, short-term mortality was compared between the study groups according to their HALP score values. The predictive ability of the HALP score for no-reflow was evaluated using a receiver operating characteristic curve.

Results

No-reflow developed in 198 (10.1%) of the patients included in the study. HALP score value was found to be significantly lower in the no-reflow group (27 ± 13 vs 47 ± 24, p < 0.001). After multivariable adjustment, the HALP score was an independent predictor of no-reflow (OR, 0.923, 95% CI, 0.910–0.935, p < 0.001). Furthermore, the HALP score showed good discrimination for no-reflow (AUC, 0.771, 95% CI, 0.737–0.805, p < 0.001). In addition, HALP score was determined to be an independent predictor for short-term mortality (HR, 0.955, 95% CI, 0.945–0.966, p < 0.001).

Conclusions

HALP score can independently predict the development of no-reflow and short-term mortality in STEMI patients undergoing pPCI.

KEYWORDS:

• STEMI
• no-reflow
• short-term mortality
• HALP score
• short-term

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Kenan Toprak, İbrahim Halil Toprak, Osman Acar, and Mehmet Fatih Ermiş contributed to the study conception and design, acquisition of data, and analysis and interpretation of data. Kenan Toprak, İbrahim Halil Toprak, Osman Acar, and Mehmet Fatih Ermiş contributed to reviewing studies, extracting data, and and drafting the work or revising it critically for important intellectual content. All authors read and approved the final version of the manuscript. The authors satisfy the authorship criteria outlined by the International Committee of Medical Journal Editors (ICMJE), and they did not receive any direct compensation pertaining to the manuscript’s development.

Ethics statement

The Harran University Faculty of Medicine’s Ethics Committee gave its approval to the study (no: 23.02.01). For every patient involved in the study, written informed consent was acquired, and all procedures were carried out in compliance with the ethical guidelines provided by the Helsinki Declaration.

Data availability statement

The study’s supporting data, which could potentially compromise research participants’ privacy, are not publicly available. However, they can be obtained from the corresponding author with a valid request.

Additional information

Funding

This paper was not funded.