Erbay İlke, Aladağ Pelin
Department of Cardiology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye.
Turk Kardiyol Dern Ars. 2025 Aug 7. doi: 10.5543/tkda.2025.71080.
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.
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.
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).
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.
2型糖尿病（T2DM）合并非ST段抬高型心肌梗死（NSTEMI）患者发生血管再通不完全及不良结局的风险增加。用于预测残余疾病负担和预后的简单生物标志物具有临床价值。血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分反映炎症和营养状况。本研究评估了HALP评分与T2DM合并NSTEMI患者的残余经皮冠状动脉介入治疗与心脏手术协同（SYNTAX）评分（rSS）及12个月主要不良心血管事件（MACE）之间的关联。
这项回顾性研究纳入了210例糖尿病患者。参与者根据rSS（0、1 - 8、> 8）分为三组。根据入院时实验室检查值计算HALP评分，并对结局进行12个月的随访。使用Spearman相关性分析和多变量回归评估HALP与rSS之间的关联。采用受试者工作特征（ROC）分析确定预测高rSS的HALP临界值。使用Cox回归和Kaplan - Meier分析评估MACE的预后价值。
rSS > 8的患者HALP评分显著更低（P < 0.001），且与rSS呈负相关（β = -0.344，P < 0.001）。预测rSS > 8的最佳HALP评分临界值为2.96，敏感性为78%，特异性为77%。HALP≤2.96的患者rSS > 8的患病率更高（43.7%对6.5%），且在12个月内发生MACE的情况更多（29.6%对13.7%，P = 0.005）。在Cox分析中，低HALP评分（≤2.96）是MACE的独立预测因素，与年龄和C反应蛋白（CRP）水平相关（风险比 = 1.916，P = 0.045）。
较低的HALP评分与较高的残余疾病负担及更差的结局相关。HALP评分可作为糖尿病NSTEMI患者风险分层的实用工具。
