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

Objective: Despite the reality 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 underwent 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 higher mortality during follow-up (log rank P < 0.0001).

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

Keywords: Coronary artery disease, elderly patient, HALP score, inflammation, mortality, malnutrition