Prognostic significance of HALP score in patients with chronic total occlusion undergoing successful PCI: a single center prospective study

The hemoglobin, albumin, lymphocytes, and platelets score (HALP) has emerged as a new promising indicator for assessing nutritional status and systemic inflammation. Evidences have been suggested that malnutrition and a low-grade inflammatory state are risk factors for cardiovascular diseases. However, the association between HALP and major adverse cardiovascular events (MACE) in patients underwent successful CTO–PCI remains undetermined. A total of 516 consecutive patients who achieved successful CTO–PCI were enrolled in this study. In total, 84 developed MACE during the follow-up period and were assigned to the MACE group. In addition, all enrolled patients were stratified into three groups according to the tertiles of HALP scores. Clinical and laboratory parameters were compared among the different groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of MACE. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of the HALP score for MACE in these patients. Patients in the MACE group had higher levels of platelet count and N-terminal pro-brain natriuretic peptide (NT-proBNP), whereas a lower level of lymphocytes count and HALP ( p < 0.05). Patients in low tertiles of HALP tended to be older and have an increased level of platelet count and creatinine (Cr), while a lower level of white blood cell (WBC) count, lymphocytes count, hemoglobin, plasma albumin (ALB), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and HALP ( p < 0.05). Lower tertiles of HALP scores was shown to associate with higher risk of TVR and composite MACE ( p < 0.001). Multivariate logistic regression analyses showed that NT-proBNP and HALP were independent predictors for MACE in patients with successful CTO–PCI. Moreover, patients in low tertiles of HALP encountered a 3.828-fold increased risk of MACE. Both HALP score and NT-proBNP are independent predictors of MACE and target-vessel revascularization (TVR) in patients with CTO who underwent successful PCI. The HALP score may serve as a simple, useful, and promising biomarker for the early identification of high-risk patients who are prone to develop MACE after successful CTO–PCI.