The Role of HALP Score in Predicting the Prognosis of FFR‐Negative Stable Coronary Artery Disease

Background Chronic coronary syndrome (CCS) is a dynamic process, and stable coronary artery plaques can progress over time and lead to ischemia. Early detection of these patients is of great importance for closer monitoring and optimization of treatment. In this study, we investigated the usefulness of the HALP score in predicting progression to critical coronary artery disease (CAD) in patients with noncritical stenosis detected by fractional flow reserve (FFR). Methods A total of 181 patients who were followed up due to CCS and whose FFR value was > 0.8 and who were decided to be followed up medically were included in the study. This is a retrospective cohort study. Patients were followed up through hospital records after the FFR date. Patients were divided into two groups for analysis: those who did not progress to critical CAD (Group 1) and those who did (Group 2). The HALP score was calculated according to the formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (10 9 /L)/platelets (10 9 /L). Results Of the 181 patients included in the study, 111 (61.3%) were male. The mean age of these patients was 60.3 ± 10.6 (min: 26, max: 83) years. Of the coronary arteries undergoing FFR, 126 (69.6%) were LAD, 20 (11.1%) were CX, and 35 (19.3%) were RCA. The mean follow‐up period after FFR was 19.9 ± 10.6 months. The mean HALP score was significantly lower in Group 2 (64.9 ± 34.8 vs 46.4 ± 18.9, p = 0.002). Cox regression analysis demonstrated low preadenosine FFR (hazard ratio [HR]: 0.897; 95% confidence interval [CI]: 0.818–0.984; p = 0.022), and low HALP score (HR: 0.980; 95% CI: 0.967–0.994; p = 0.004) as independent predictors of PCI requirement during follow‐up. As a predictor of PCI requirement during follow‐up, the ROC curve analysis revealed a sensitivity of 65% and specificity of 61% for HALP score < 50.5 (area under the curve [AUC] 0.673, 95% CI: 0.582–0.764, p = 0.001). Conclusion Low HALP score may be a predictor of progression of noncritical coronary artery plaques in patients with CCS.