Browsing by Author "Guzel, Tuncay"

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Ability of Cha2ds2-vasc/R2cha2ds2-vasc Scores To Predict Complications Related To Cardiac Implantable Electronic Devices
(Wiley, 2025) Soner, Serdar; Aktan, Adem; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
BackgroundGlobally, the number of cardiac implantable electronic devices (CIEDs) is increasing. In our study, we aimed to investigate whether CHA(2)DS(2)-VASc and R(2)CHA(2)DS(2)-VASc scores are predictive of CIED-related complications. MethodsOur investigation was carried out with a multicenter retrospective design. Patients who underwent CIED surgery at two cardiac centers in Turkey between January 2011 and May 2023, 1676, were evaluated. The patients were divided into two groups according to their R(2)CHA(2)DS(2)-VASc scores. Patients with R(2)CHA(2)DS(2)-VASc >= 5 were included in group 1 (380 patients), and patients with R(2)CHA(2)DS(2)-VASc < 5 (1296 patients) were included in group 2. The primary outcome was defined as the cumulative events. Each component of cumulative events, such as hematoma, pericardial effusion, pneumothorax, and infection, was also defined as a secondary outcome. ResultsThe study's patient population had an average age of 62.9 +/- 14 years. Pneumothorax (1.8% vs. 1.3%, p = 0.444), pericardial effusion or tamponade (0.35% vs. 0.2%, p = 0.659), and clinically significant hematoma (1.1% vs. 0.6%, p = 0.376) were comparable between the groups. Infection-related devices and cumulative events classified as primary outcomes were higher in the R(2)CHA(2)DS(2)-VASc >= 5 group (6.1% vs. 1.2%, p < 0.001; 7.6% vs. 3.2%, p < 0.001, respectively). Modeling analyses showed that the CHA(2)DS(2)-VASc score and HT were also independent predictors of device-related infection and cumulative events. ConclusionIn the R(2)CHA(2)DS(2)-VASc >= 5 groups, infection related to the device system and cumulative events were higher. Patients with an R(2)CHA(2)DS(2)-VASc score of 5 or more and a high CHA(2)DS(2)-VASc score should be evaluated more carefully regarding infection and cumulative events before and after the operation.
Citation - WoS: 1
Citation - Scopus: 1
Association Between the Triglyceride-Glucose Index and Contrast-Induced Nephropathy in Chronic Total Occlusion Patients Undergoing Percutaneous Coronary Intervention
(Bmc, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. Contrast-induced nephropathy (CIN) is an important complication that causes poor outcomes in patients undergoing percutaneous coronary intervention (PCI). In this study, we aimed to investigate the relationship between the TyG index and CIN and mortality in patients who underwent PCI due to chronic total coronary occlusion (CTO). Methods Two hundred eighteen individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index >= 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality. Results The mean age of the patients (65.8 +/- 10.94 vs. 61.68 +/- 11.4, P = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], P < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], P = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01-1.08, P = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02-5.33, P = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24-25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92-0.99, P = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, P = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21-3.89, P = 0.009) were independent predictors of the development of CIN. Conclusion Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.
Citation - WoS: 1
Citation - Scopus: 1
Comparison of Evolut-R 34 Mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors
(Kare Publ, 2024) Aktan, Adem; Kilic, Raif; Kılıç, Raif; Guzel, Tuncay; Aktan, Adem; Günlü, Serhat; Demir, Muhammed; Gunlu, Serhat; Arslan, Bayram; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective: The main purpose of this study was to evaluate and compare the in -hospital, 1 -month and 1 -year post -procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of >= mild paravalvular leaks (PVL). Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed. Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P < .001, respectively), ejection fraction (50.7 +/- 10.1% vs. 54.5 +/- 9.3%, P = .016, respectively), and mean aortic gradient (7.4 +/- 3.3 vs. 9.2 +/- 5.0, P = .026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant pre- dictor of >= mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P = .019) and calcium volume 800 Hounsfield Units (mm(3)) (OR = 1.017; P < .001) were independent predictors of >= mild PVL. Conclusion: The Evolut-R 34 mm valve has shown comparable in -hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted >= mild PVL in Evolut-R 34 mm patients.
Citation - WoS: 8
Citation - Scopus: 8
Comparison of Pain Levels of Traditional Radial, Distal Radial, and Transfemoral Coronary Catheterization
(Assoc Medica Brasileira, 2023) Günlü, Serhat; Kılıç, Raif; Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Aktan, Adem; Arslan, Bayram; Karahan, Mehmet Zülkif; Aslan, Muzaffer; Gunlu, Serhat; Karahan, Mehmet Zulkuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale.METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7 & PLUSMN;1.6, traditional radial artery: 3.9 & PLUSMN;1.9, and distal radial artery: 4.9 & PLUSMN;2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724-0.815, p<0.0001)].CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.
Citation - WoS: 2
Citation - Scopus: 2
The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement
(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Aslan, Burhan; Kilic, Raif; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in -hospital complications as well as mortality of patients undergoing Evolut (TM) R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium -3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in -hospital mortality. Patients were divided into two groups, AA <= 48(degrees) and AA > 48(degrees), based on the mean AA measurement (48.3 +/- 8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.
Citation - WoS: 3
Citation - Scopus: 6
The Effectiveness of Halp Score in Predicting Mortality in Non-St Myocardial Infarction Patients
(Lippincott Williams & Wilkins, 2025) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Cankaya, Yusuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background:The HALP score, measured based on hemoglobin, albumin, lymphocyte, and platelet levels, is regarded as a novel scoring system that indicates the status of systemic inflammation and nutritional health. Our study aimed to evaluate the relationship between HALP score and prognosis in non-ST-elevation myocardial infarction (NSTEMI) patients. Methods Between 1 January 2020 and 1 January 2022, 568 consecutive patients diagnosed with NSTEMI from a single center were included in the study retrospectively. The patients were divided into two equal groups according to the median HALP cutoff value of 44.05. Patients were followed for at least 1 year from the date of admission. Results The average age of the patients was 62.3 +/- 10.6 years and 43.7% were female. In-hospital and 1-year mortality were found to be significantly higher in the group with low HALP scores (6.0 vs. 2.1%, P = 0.019 and 22.5 vs. 9.9%, P < 0.001, respectively). In receiver operating characteristic curve analysis, a cutoff level of 34.6 of the HALP score predicted 1-year mortality with 71% sensitivity and 65% specificity (area under the curve: 0.707, 95% confidence interval: 0.651-0.762, P < 0.001). In Kaplan-Meier analysis, higher mortality rates were observed over time in the group with lower HALP scores (log-rank test=16.767, P < 0.001). In Cox regression analysis, the HALP score was found to be an independent predictor of 1-year mortality (odds ratio: 0.969, 95% confidence interval: 0.958-0.981, P < 0.001). Conclusion We found that a low HALP score could predict in-hospital and 1-year mortality in patients admitted to the hospital with a diagnosis of NSTEMI.
The Naples Prognostic Score in TAVI Patients: a Promising Tool Requiring Further Validation. Authors' Reply
(Polish Cardiac Soc, 2025) Aktan, Adem; Guzel, Tuncay; Kis, Mehmet; Coskun, Ferhat; Isik, Mehmet Ali; Aktan, Adem; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
A Novel Determinant of Prognosis in Acute Pulmonary Edema: Intermountain Risk Score
(Kare Publ, 2024) Aktan, Adem; Aktan, Adem; Guzel, Tuncay; Kaya, Ahmet Ferhat; Guzel, Hamdullah; Arslan, Bayram; Cankaya, Yusuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective: The Intermountain Risk Score (IMRS), calculated using age, gender, complete blood count (CBC), and simple laboratory analyses, is an easy-to-use and cost-effective tool developed to predict mortality. In our study, we aimed to determine whether the IMRS could predict mortality in patients admitted to the hospital with a diagnosis of acute pulmonary edema. Methods: A total of 371 patients who were admitted with a diagnosis of pulmonary edema, were included in our study. The IMRS of the patients was determined using a calculation tool, and the patients were divided into three groups based on the determined value: low, moderate, and high IMRS. Results: The patients included in our study comprised 208 women and 163 men, with an average age of 68.7 years. There was a statistically significant difference between the patient groups concerning both 1-month and 1-year mortality rates. Additionally, there was a significant difference in IMRS between patients who developed in-hospital, 1-month, and 1-year mortality and those who survived. In the Receiver Operating Characteristic (ROC) analysis, a cutoff value of 15.5 for the IMRS predicted both 1-year and 1-month mortality. In the Kaplan-Meier analysis, the highest mortality risk was observed in the high IMRS group and the lowest mortality risk in the low IMRS group. Conclusion: Our research results show that the IMRS strongly predicts both short-term and long-term mortality in patients hospitalized with a diagnosis of acute pulmonary edema.
Citation - WoS: 4
Citation - Scopus: 4
The Performance of the Naples Prognostic Score in Predicting One-Year Mortality and Major Adverse Cardiovascular Events After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis
(Polish Cardiac Soc, 2025) Aktan, Adem; Guzel, Tuncay; Kis, Mehmet; Coskun, Ferhat; Isik, Mehmet Ali; Aktan, Adem; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Existing risk scores for transcatheter aortic valve implantation (TAVI) may not fully capture patient complexity. Combining nutritional and inflammatory markers, the NPS (the NAPLES prognostic score) might improve outcome prediction. Aims: This study investigated the associations of the NPS with one-year mortality and major adverse cardiovascular events (MACEs) in TAVI patients. Material and methods:This retrospective analysis included 222 patients with severe aortic stenosis who underwent TAVI. The NPS was calculated based on the serum alb & uuml;min concentration, cholesterol concentration, lymphocyte/monocyte ratio, and neutrophil/lymphocyte ratio. The patients were subsequently categorized into two groups: the low-NPS group (NPS 0-2) and the high-NPS group (NPS 3-4). Results: A high NPS was significantly associated with increased one-year mortality (4.8% vs. 23.7%; P <0.001) and MACE rates (7.2% vs. 35.9%; P <0.001). Cox regression analysis demonstrated that a high NPS was an independent predictor of both mortality (HR, 5.94; 95% CI, 2.03-17.37; P = 0.001) and MACEs (HR, 5.09; 95% CI, 2.15-12.02; P <0.001). Conclusions: The NPS emerged as a potential predictor of long-term mortality and MACEs in TAVI patients. Further validation through larger, multicenter, studies is warranted.This research contributes valuable data on the role of the NPS in TAVI risk stratification.
Citation - WoS: 1
Citation - Scopus: 1
Predictive Value of Nutritional Scores in Non-Valvular Atrial Fibrillation Patients: Insights From the After-2 Study
(Elsevier Sci Ltd, 2025) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Demir, Muhammed; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and aim: Many scoring systems are used to evaluate malnutrition, but there is no consensus on which scoring system would be more appropriate. We aimed to investigate the effect of malnutrition in patients with non-valvular atrial fibrillation (NVAF) and to compare three scoring systems. Methods and results: A total of 2592 patients with non-valvular AF from 35 different centers in Turkey were included in this prospective study. All participants were divided into two groups: 761 patients who died and 1831 patients who were alive. The malnutrition status of all participants was evaluated with three scoring systems. The primary outcome was all-cause mortality. The mean age of the population was 68.7 +/- 11.1 years, and 55.5 % were female. According to Cox regression analysis, the geriatric nutritional risk index (GNRI) (HR = 0.989, 95 % CI: 0.982-0.997, p = 0.007), controlling nutritional status (CONUT) score (HR = 1.121, 95 % CI: 1.060-1.185, p < 0.001), and prognostic nutritional index (PNI) (HR = 0.980, 95 % CI: 0.962-0.999, p = 0.036) were found to be significant mortality predictors. ROC curve analysis indicated GNRI (AUC = 0.568), CONUT (AUC = 0.572), and PNI (AUC = 0.547) had moderate predictive values. Kaplan-Meier analysis showed that increasing the risk class based on GNRI (p < 0.001) and CONUT (p < 0.001) was associated with decreased survival, while PNI staging had no statistically significant effect (p = 0.266). Conclusions: Malnutrition, determined by three scoring systems, was found to be an independent predictor of all-cause mortality in NVAF patients. Nutritional examination may provide useful information for prognosis and risk stratification in patients with NVAF.
The Predictive Value of the Cha2ds2-Vasc Score in the Development of Contrast-Induced Nephropathy After Endovascular Intervention in Peripheral Artery Disease
(Elsevier Science inc, 2025) Aktan, Adem; Aktan, Adem; Kilic, Raif; Isik, Mehmet Ali; Yalcin, Abdulaziz; Guzel, Tuncay; Ozbek, Mehmet; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Contrast-induced nephropathy (CIN) is a frequent complication of endovascular interventions for peripheral artery disease (PAD). It is linked to renal dysfunction, extended hospital stays, increased cardiovascular events, and higher mortality rates. The CHA2DS2-VASc score, widely utilized for assessing cardioembolic risk and guiding anticoagulation therapy in nonvalvular atrial fibrillation, encompasses risk factors that overlap with those of CIN. This study investigates whether the CHA2DS2-VASc score can predict CIN in PAD patients undergoing endovascular interventions. Methods: The study included 754 consecutive PAD patients who underwent endovascular procedures at 2 centers. Each patient's CHA2DS2-VASc score was calculated and categorized into low (<3) and high (>= 3) groups. Patients were retrospectively monitored for CIN development and divided into CIN-positive (CIN+) and CIN-negative (CIN-) groups. Univariate and multivariate regression analyses were performed to identify independent predictors of CIN, and a significance level of P < 0.05 was used for all statistical analyses. Results: Of the 754 patients, 178 (23.6%) developed CIN, with 151 (84.8%) occurring in the high CHA2DS2-VASc score group (P < 0.001). The CHA2DS2-VASc score was significantly higher in the CIN(+) group compared to the CIN(-) group (P < 0.001). Regression analysis identified the CHA2DS2-VASc score (odds ratio [OR]: 1.574, 95% confidence interval [CI]: 1.2981.907, P < 0.001), baseline creatinine (OR: 2.296, 95% CI: 1.580-3.335, P < 0.001), and hemoglobin (OR: 0.915, 95% CI: 0.844-0.992, P < 0.001) as independent risk factors. A CHA2DS2-VASc score cutoff of 2.5 predicted CIN with 85% sensitivity and 42% specificity. Conclusion: The CHA2DS2-VASc score is an independent predictor of the development of CIN in patients with PAD undergoing endovascular intervention.
Citation - WoS: 2
Citation - Scopus: 4
Prevalence of Sarcopenia in Heart Failure With Mildly Reduced Ejection Fraction and Its Impact on Clinical Outcomes
(Taylor & Francis Ltd, 2024) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Arslan, Bayram; Karahan, Mehmet Zuelkuef; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Sarcopenia is a progressive age-related skeletal muscle disease associated with adverse outcomes in those with cardiovascular disease. In this study, the prevalence of sarcopenia and its effect on clinical outcomes in heart failure with mildly reduced ejection fraction (HFmrEF) patients were examined. Methods: A total of 722 patients from three centres who applied to the outpatient clinic with the diagnosis of HFmrEF between 01 January 2020 and 01 June 2021 were included in the study retrospectively. Sarcopenia was diagnosed with a screening test using age, grip srength and calf circumference. At least two-year follow-up results were reviewed from the date the patients were included in the study. Results: Of the 722 HFmrEF patients, 169 (23.4%) were sarcopenic. During the follow-up of sarcopenic patients, a higher rate of hospitalisation and two-year mortality was detected compared to the non-sarcopenic group (49.7% vs 33.3%, p < .001 and 23.7% vs 13.2%, p = .001, respectively). Additionally, atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and smoking were detected at higher rates in sarcopenic patients. In subgroup analysis, AF was found to be significantly higher in overweight/obese sarcopenia patients compared to other groups. According to Receiver operating characteristic (ROC) analysis, the sarcopenia score cut-off of 73.61 predicted mortality with 65% sensitivity and 63% specificity, and the cut-off level of 71.10 predicted hospitalisation with 68% sensitivity and 69% specificity. Conclusion: In HFmrEF patients, sarcopenia is associated with adverse events and is an important prognostic marker.
Prognostic Value of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Scores in Patients With Non-Valvular Atrial Fibrillation: Insights From the After-2 Study
(BMC, 2025) Soner, Serdar; Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Soner, Hulya Tosun; Demir, Muhammed; Ertas, Faruk
Objectives: The relationship between hemoglobin, albumin, lymphocyte, platelet (HALP) score, and various cancers and cardiovascular diseases has been tested previously. However, the relationship between HALP score and non-valvular atrial fibrillation (NVAF) has not been adequately tested. Therefore, our study aimed to investigate the relationship between HALP score and mortality in patients with NVAF. Methods: This study included 2,592 NVAF patients from 35 centers in Turkey. Patients were divided into two groups: those with HALP scores <= 58.96 (low HALP score group, 1,296 patients) and > 58.96 (high HALP score group, 1,296 patients). The primary outcome measured was all-cause mortality. Results: The mean HALP score was 66 +/- 33. Patients in the low HALP score group had higher 1- and 5-year all-cause mortality rates (1-year: 12.9% vs. 5.4%, p < 0.001; 5-year: 38.5% vs. 20.2%, p < 0.001). Cox regression analysis identified the HALP score as an independent predictor of mortality (1-year: HR = 0.987, 95% CI = 0.981-0.992, p < 0.001; 5-year: HR = 0.990, 95% CI = 0.987-0.993, p < 0.001). ROC analysis determined a HALP score 52.3 predicted 1-year mortality with 62.9% sensitivity and 62% specificity (AUC = 0.680); a score of 55 predicted 5-year mortality with 60.3% sensitivity and 62.2% specificity (AUC = 0.657). Kaplan-Meier analysis revealed increasing mortality over time in the low HALP score group (log-rank tests, 1-year = 44.86, p < 0.001; 5-year = 108.54, p < 0.001). Conclusions: The HALP score is a simple, accessible measure, and our findings suggest that lower HALP scores are associated with increased 1-year and 5-year mortality in NVAF patients. This provides a reference for clinicians assessing risk in this vulnerable population.