The HALP Score's Prognostic Value for the Elderly (≥75 years) Patients Following Percutaneous Coronary Intervention for Acute Myocardial Infarction.

Cemalettin Yılmaz, İsmail Üngan, Enes Arslan, Emrah Çitil, Ömer Uluuysal, Muhammet Mücahit Tiryaki, Doğan Şen, Ahmet Karaduman, Regayip Zehir
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Abstract

Objective: Despite the fact that percutaneous coronary intervention (PCI) lowers mortality following acute myocardial infarction (AMI), older patients (≥75 years) are still at high risk of mortality. The purpose of this study was to evaluate the prognostic significance of the HALP score, which reflects the inflammatory and nutritional status, in this population.

Method: We retrospectively included 128 elderly patients who had PCI at our institution between 2019 and 2022. The primary endpoint of the study was long-term all-cause mortality. The study population was categorized into two distinct groups based on survival status: survivors and non-survivors. A multivariable Cox regression analysis was conducted to identify independent predictors of long-term all-cause mortality.

Results: The median follow-up time was 49.9 (35.6-62.74) months. In multivariable analysis, the HALP score and CRP independently predicted all-cause mortality at long-term follow-up (hazard ratio (HR): 0.96, 95% confidence interval (CI): 0.94-0.99, p=0.003; HR: 1.04, 95% CI: 1.01-1.07, p=0.020; respectively). Receiver operating characteristic curve analysis identified 26.252 as the optimal HALP score cut-off for predicting mortality (area under the curve (AUC): 0.764; 95% CI: 0.672-0.855; p< 0.001), with 73% sensitivity and 70.3% specificity. The HALP score demonstrated a higher AUC value, indicating better discriminative power compared to its individual components. In Kaplan-Meier analysis, patients with HALP score< 26.252 had a greater follow-up death (log rank p< 0.0001).

Conclusion: The HALP score is an independent predictor of long-term all-cause death in older AMI patients following PCI.

HALP评分对老年(≥75岁)急性心肌梗死经皮冠状动脉介入治疗患者的预后价值
目的:尽管经皮冠状动脉介入治疗(PCI)降低了急性心肌梗死(AMI)后的死亡率,但老年患者(≥75岁)仍有较高的死亡率。本研究的目的是评估反映该人群炎症和营养状况的HALP评分的预后意义。方法:我们回顾性地纳入了2019年至2022年在我院接受PCI治疗的128例老年患者。研究的主要终点是长期全因死亡率。研究人群根据生存状况分为两组:幸存者和非幸存者。进行多变量Cox回归分析以确定长期全因死亡率的独立预测因素。结果:中位随访时间为49.9(35.6 ~ 62.74)个月。在多变量分析中,HALP评分和CRP独立预测长期随访时的全因死亡率(风险比(HR): 0.96, 95%可信区间(CI): 0.94-0.99, p=0.003;HR: 1.04, 95% CI: 1.01 ~ 1.07, p=0.020;分别)。受试者工作特征曲线分析确定26.252为预测死亡率的最佳HALP分值(曲线下面积(AUC): 0.764;95% ci: 0.672-0.855;P < 0.001),敏感性为73%,特异性为70.3%。HALP得分显示出较高的AUC值,表明与其单个组成部分相比具有更好的判别能力。Kaplan-Meier分析显示,HALP评分< 26.252的患者随访死亡率更高(log rank p< 0.0001)。结论:HALP评分是PCI术后老年AMI患者长期全因死亡的独立预测因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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