Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
The HALP Score and Its Association With Coronary Collateral Circulation Development in Chronic Total Occlusion Patients.
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Süleymanoğlu Cuma, Polat Fuat, Paçacı Emre, Terzi Sait
Аннотация
BACKGROUND: Coronary collateral circulation plays a crucial compensatory role in patients with chronic total occlusion (CTO) by providing alternative blood flow pathways. The HALP score (hemoglobin, albumin, lymphocyte, and platelet) integrates systemic inflammation and nutritional status, but its relationship with collateral development in CTO patients remains unexplored.
AIMS: This study aimed to evaluate the association between HALP score and coronary collateral circulation quality assessed by Werner classification in CTO patients.
METHODS: This retrospective cross-sectional study included 240 consecutive CTO patients who underwent coronary angiography. HALP score was calculated using the formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/μL)/platelets (/μL). Collateral circulation was graded using the Werner classification (CC0-CC3), with good collateral defined as a CC score ≥ 2. Correlation analysis, ROC curve analysis, and multivariate logistic regression were performed to assess the relationship between HALP score and collateral circulation.
RESULTS: The median HALP score was 4.20 (IQR: 2.68-5.68). A significant positive correlation was observed between HALP score and Werner grade (r = 0.807, p < 0.001, R² = 0.652). Median HALP scores increased progressively across Werner grades: CC0 (1.62), CC1 (3.20), CC2 (4.80), and CC3 (7.70). In multivariate analysis, the HALP score was significantly associated with good collateral circulation (OR: 3.762, 95% CI: 2.182-6.486, p < 0.001). The optimal cutoff of 3.509 demonstrated good diagnostic performance with 90.7% sensitivity and 66.7% specificity (AUC: 0.885).
CONCLUSIONS: HALP score is significantly associated with coronary collateral circulation development in CTO patients. This simple, cost-effective biomarker appears promising for risk stratification in this population based on this preliminary analysis, though prospective validation is needed before clinical application.
AIMS: This study aimed to evaluate the association between HALP score and coronary collateral circulation quality assessed by Werner classification in CTO patients.
METHODS: This retrospective cross-sectional study included 240 consecutive CTO patients who underwent coronary angiography. HALP score was calculated using the formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/μL)/platelets (/μL). Collateral circulation was graded using the Werner classification (CC0-CC3), with good collateral defined as a CC score ≥ 2. Correlation analysis, ROC curve analysis, and multivariate logistic regression were performed to assess the relationship between HALP score and collateral circulation.
RESULTS: The median HALP score was 4.20 (IQR: 2.68-5.68). A significant positive correlation was observed between HALP score and Werner grade (r = 0.807, p < 0.001, R² = 0.652). Median HALP scores increased progressively across Werner grades: CC0 (1.62), CC1 (3.20), CC2 (4.80), and CC3 (7.70). In multivariate analysis, the HALP score was significantly associated with good collateral circulation (OR: 3.762, 95% CI: 2.182-6.486, p < 0.001). The optimal cutoff of 3.509 demonstrated good diagnostic performance with 90.7% sensitivity and 66.7% specificity (AUC: 0.885).
CONCLUSIONS: HALP score is significantly associated with coronary collateral circulation development in CTO patients. This simple, cost-effective biomarker appears promising for risk stratification in this population based on this preliminary analysis, though prospective validation is needed before clinical application.
Предметные рубрики MeSH
HumansCollateral CirculationCoronary OcclusionFemaleMaleRetrospective StudiesCoronary AngiographyCross-Sectional StudiesChronic DiseaseAgedPredictive Value of TestsMiddle AgedCoronary CirculationBiomarkersROC CurvePlatelet CountHemoglobinsLymphocyte CountRisk FactorsSerum Albumin, HumanLogistic ModelsMultivariate Analysis