The Hemoglobin, Albumin, Lymphocyte, and Platelet Score as a Simple Blood-Based Predictor of Residual Coronary Disease Burden in Diabetic Patients with Non-ST-Elevation Myocardial Infarction.

Abstract

Objective: Patients with type 2 diabetes mellitus (T2DM) and non-ST-elevation myocardial infarction (NSTEMI) are at increased risk of incomplete revascularization and adverse outcomes. Simple biomarkers to predict residual disease burden and prognosis are clinically valuable. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score reflects inflammation and nutritional status. This study evaluated the association of the HALP score with the residual Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (rSS) and 12-month major adverse cardiovascular events (MACE) in T2DM patients with NSTEMI.

Method: This retrospective study included 210 diabetic patients. Participants were stratified into three groups based on rSS (0, 1-8, > 8). HALP scores were calculated from admission laboratory values, and outcomes were followed for 12 months. Associations between HALP and rSS were assessed using Spearman correlation and multivariable regression. Receiver operating characteristic (ROC) analysis identified a HALP cut-off value for predicting high rSS. The prognostic value for MACE was evaluated using Cox regression and Kaplan-Meier analysis.

Results: HALP scores were significantly lower in patients with rSS > 8 (P < 0.001) and were negatively associated with rSS (β = -0.344, P < 0.001). The optimal HALP score cut-off for predicting rSS > 8 was 2.96, with 78% sensitivity and 77% specificity. Patients with HALP ≤ 2.96 had a higher prevalence of rSS > 8 (43.7% vs. 6.5%) and experienced more MACE over 12 months (29.6% vs. 13.7%, P = 0.005). In Cox analysis, a low HALP score (≤ 2.96) was an independent predictor of MACE, along with age and C-reactive protein (CRP) levels (hazard ratio = 1.916, P = 0.045).

Conclusion: Lower HALP scores are associated with higher residual disease burden and worse outcomes. The HALP score may serve as a practical tool for risk stratification in patients with diabetic NSTEMI.