SavedAdd your journal

Journals / Anatolian Current Medical Journal / 2026 / Volume: 7 Issue: 1

HALP score can predict the no-reflow phenomenon and in-hospital mortality after saphenous vein graft intervention

Ömer Furkan Demir(Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi)0000-0002-0230-8442
Barış Şensoy(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0003-0066-9946
Pages
—
Publication Date
2025-01-10
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: The HALP score proves to be a valuable predictive tool for NRP and in-hospital mortality in patients with presenting to the emergency department with ACS and undergoing SVG intervention.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: The no-reflow phenomenon (NRP) is one of the most frequently observed complications in saphenous vein graft (SVG) interventions.
📊
Key Findings & Data:Methods: This retrospective study included 263 patients who applied to our center with the diagnosis of ACS and underwent saphenous vein grafting procedure.
💡
Conclusion & Impact:Conclusion: The HALP score proves to be a valuable predictive tool for NRP and in-hospital mortality in patients with presenting to the emergency department with ACS and undergoing SVG intervention.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:HALP score · no-reflow phenomenon · saphenous vein graft

Abstract

Aims: The no-reflow phenomenon (NRP) is one of the most frequently observed complications in saphenous vein graft (SVG) interventions. The aim of this study was to investigate the effect of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score on the development of NRP in patients with acute coronary syndrome (ACS) undergoing percutaneous SVG intervention. Methods: This retrospective study included 263 patients who applied to our center with the diagnosis of ACS and underwent saphenous vein grafting procedure. 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, in-hospital 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: NRP developed in 103 (39.2%) of the patients included in the study patients. HALP score value was found to be significantly lower in the no-reflow group (45.3±20 vs 53.8±18, p:0.001). In the receiver operating characteristic (ROC) analysis, the cutoff value for the HALP score was calculated as 46.5. After multivariable adjustment, the HALP score <46.5 was an independent predictor of no-reflow (OR=4.95, 95% CI:2.48-9.89; p<0.001). Additionally, HALP score was found to be an indicator for in-hospital mortality (0.036). Conclusion: The HALP score proves to be a valuable predictive tool for NRP and in-hospital mortality in patients with presenting to the emergency department with ACS and undergoing SVG intervention.

🔖

Cite This Article

Demir, Ö. F., Şensoy, B. (2025). HALP score can predict the no-reflow phenomenon and in-hospital mortality after saphenous vein graft intervention. Anatolian Current Medical Journal, Volume: 7 Issue: 1. https://doi.org/10.38053/acmj.1549660

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (30)

  1. de Vries MR, Quax PHA. Inflammation in Vein Graft Disease. Front Cardiovasc Med. 2018;5:3. doi:10.3389/fcvm.2018.00003
  2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization [published correction appears in Eur Heart J. 2019;40(37):3096. doi:10.1093/eurheartj/ehz507]. Eur Heart J. 2019;40(2):87-165. doi:10.1093/eurheartj/ehy394
  3. Harskamp RE, Lopes RD, Baisden CE, de Winter RJ, Alexander JH. Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions. Ann Surg. 2013; 257(5):824-833. doi:10.1097/SLA.0b013e318288c38d
  4. Lee MS, Park SJ, Kandzari DE, et al. Saphenous vein graft intervention. JACC Cardiovasc Interv. 2011;4(8):831-843. doi:10.1016/j.jcin.2011.05.014
  5. Soverow J, Lee MS. Saphenous vein graft intervention: status report 2014. J Invasive Cardiol. 2014;26(12):659-667.
  6. Salinas P, Jimenez-Valero S, Moreno R, et al. Update in pharmacological management of coronary no-reflow phenomenon. Cardiovasc Hematol Agents Med Chem. 2012;10(3):256-264. doi:10.2174/187152512802651024
  7. Gürbak İ, Panç C, Şahin AA, et al. CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes. Kardiol Pol. 2020;78(11):1129-1136. doi:10.33963/KP.15603
  8. De Luca G, Suryapranata H, Marino P. Reperfusion strategies in acute ST-elevation myocardial infarction: an overview of current status. Prog Cardiovasc Dis. 2008;50(5):352-382. doi:10.1016/j.pcad.2007.11.004
  9. Gupta S, Gupta MM. No reflow phenomenon in percutaneous coronary interventions in ST-segment elevation myocardial infarction. Indian Heart J. 2016;68(4):539-551. doi:10.1016/j.ihj.2016.04.006
  10. Montone RA, Camilli M, Del Buono MG, et al. “No-reflow”: update su diagnosi, fisiopatologia e strategie terapeutiche [No-reflow: update on diagnosis, pathophysiology and therapeutic strategies]. G Ital Cardiol (Rome). 2020;21(6 Suppl 1):4S-14S. doi:10.1714/3373.33487
  11. Antar R, Farag C, Xu V, Drouaud A, Gordon O, Whalen MJ. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES. Front Nutr. 2023;10:1206958. doi:10.3389/fnut.2023.1206958
  12. Akbar KMA, Dharma S, Andriantoro H, Sukmawan R, Mangkuanom AS, Rejeki VG. Relationship between hemoglobin concentration at admission with the incidence of no-reflow phenomenon and in-hospital mortality in acute myocardial infarction with elevation of st segments in patients who underwent primary percutaneous coronary intervention. Int J Angiol. 2022;32(2):106-112. doi:10.1055/s-0042-1742308
  13. Zhao Y, Yang J, Ji Y, et al. Usefulness of fibrinogen-to-albumin ratio to predict no-reflow and short-term prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Heart Vessels. 2019;34(10):1600-1607. doi:10.1007/s00380-019-01399-w
  14. Karakayali M, Omar T, Artac I, et al. The prognostic value of HALP score in predicting in-hospital mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Coron Artery Dis. 2023;34(7):483-488. doi:10.1097/MCA. 0000000000001271
  15. Kirma C, Izgi A, Dundar C, et al. Clinical and procedural predictors of no-reflow phenomenon after primary percutaneous coronary interventions: experience at a single center. Circ J. 2008;72(5):716-721. doi:10.1253/circj.72.716
  16. Sianos G, Papafaklis MI, Serruys PW. Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. J Invasive Cardiol. 2010;22(10 Suppl B):6B-14B.
  17. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237-269. doi:10. 1093/eurheartj/ehy462
  18. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S13-S27. doi:10.2337/dc18-S002
  19. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med. 1999;130(6):461-470. doi:10. 7326/0003-4819-130-6-199903160-00002
  20. Xu H, Zheng X, Ai J, Yang L. Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: a systematic review and meta-analysis of 13,110 patients. Int Immunopharmacol. 2023;114: 109496. doi:10.1016/j.intimp.2022.109496
  21. Xu SS, Li S, Xu HX, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol. 2020;26(8):828-838. doi:10.3748/wjg.v26.i8.828
  22. Tian M, Li Y, Wang X, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is associated with poor outcome of acute ischemic stroke. Front Neurol. 2021;11:610318. doi:10.3389/fneur.2020.610318
  23. Toprak K, Toprak İH, Acar O, Ermiş MF. The predictive value of the HALP score for no-reflow phenomenon and short-term mortality in patients with ST-elevation myocardial infarction. Postgrad Med. 2024; 136(2):169-179. doi:10.1080/00325481.2024.2319567
  24. Kaur G, Baghdasaryan P, Natarajan B, et al. Pathophysiology, diagnosis, and management of coronary no-reflow phenomenon. Int J Angiol. 2021; 30(1):15-21. doi:10.1055/s-0041-1725979
  25. Roche M, Rondeau P, Singh NR, Tarnus E, Bourdon E. The antioxidant properties of serum albumin. FEBS Lett. 2008;582(13):1783-1787. doi: 10.1016/j.febslet.2008.04.057
  26. Bouleti C, Mewton N, Germain S. The no-reflow phenomenon: State of the art. Arch Cardiovasc Dis. 2015;108(12):661-674. doi:10.1016/j.acvd. 2015.09.006
  27. Rezkalla SH, Dharmashankar KC, Abdalrahman IB, Kloner RA. No-reflow phenomenon following percutaneous coronary intervention for acute myocardial infarction: incidence, outcome, and effect of pharmacologic therapy. J Interv Cardiol. 2010;23(5):429-436. doi:10. 1111/j.1540-8183.2010.00561.x
  28. Özen Y, Bilal Özbay M. Assessment of systemic immune-inflammation index as an independent surrogate biomarker of no-reflow phenomenon in acute coronary syndrome patients with coronary artery bypass grafting undergoing percutaneous coronary intervention of saphenous vein graft. Eur Rev Med Pharmacol Sci. 2023;27(6):2394-2403. doi:10. 26355/eurrev_202303_31774
  29. Hashemi-Jazi M, Hosseini SM, Gholamrezaei A. Factors associated with the no-reflow phenomenon following percutaneous intervention of saphenous vein coronary bypass grafts. ARYA Atheroscler. 2017;13(5): 221-229.
  30. Leborgne L, Cheneau E, Pichard A, et al. Effect of direct stenting on clinical outcome in patients treated with percutaneous coronary intervention on saphenous vein graft. Am Heart J. 2003;146(3):501-506. doi:10.1016/S0002-8703(03)00309-0