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

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,  < 0.001). After multivariable adjustment, the HALP score was an independent predictor of no-reflow (OR, 0.923, 95% CI, 0.910-0.935,  < 0.001). Furthermore, the HALP score showed good discrimination for no-reflow (AUC, 0.771, 95% CI, 0.737-0.805,  < 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,  < 0.001).

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