Clinical implications of immunonutritional status in cancer patients undergoing percutaneous coronary intervention: insights from the SAKURA PCI2 Antithrombotic Registry

Background The immunonutritional status, as assessed by the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, has been linked to poor prognosis in various cancer patients. However, the clinical implications of the HALP score remain unclear in cancer patients undergoing percutaneous coronary intervention (PCI). Purpose This study aimed to clarify the association between the HALP score and clinical prognosis in cancer patients undergoing PCI. Methods We retrospectively analyzed 709 patients who underwent PCI from June 2020 to July 2022 in the SAKURA PCI2 Antithrombotic Registry, a prospective multicenter registry. Cancer patients were stratified into high or low HALP score groups based on an optimal cut-off value of 51.3. The primary outcome was defined as two-year all-cause mortality. Results Of the study participants, 99 patients (14.0%) had a cancer history. Cancer patients had significantly lower HALP scores than noncancer patients (57.0 [34.2-83.3] vs. 72.1 [45.5-108.0], p<0.01). Cancer patients with a low HALP score had higher mortality than those with a high HALP score and noncancer patients (35.4% vs. 9.7%. vs. 7.6%, p< 0.01). Compared to noncancer patients, Cancer patients with a low HALP score had a 3.11-fold increased risk of mortality (adjusted HR 3.11, 95%CI 1.67-5.78, p<0.01), whereas those with a high HALP score had a similar risk (adjusted HR 1.44, 95%CI 0.56-3.69, p=0.45). In the cancer patient cohort, a decrease in the HALP score was associated with mortality (adjusted HR 1.02, 95%CI 1.00-1.04, p=0.03). Conclusion A low HALP score in cancer patients was associated with an increased risk of two-year mortality. Therefore, the HALP score may provide valuable information for risk stratification in cancer patients undergoing PCI.Outcome