Cardiovascular

Association of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score with Contrast-Associated Acute Kidney Injury and Mortality in Patients Underwent Coronary Angiography: A Multicenter Retrospective Cohort Study.

Yang X, Zhu J, et al. • Vascular health and risk management • 2026

Cohort PubMed 42890371 DOI 10.2147/VHRM.S634088
TL;DR

The HALP score was independently associated with CA-AKI, all-cause mortality, and cardiovascular mortality among patients undergoing coronary angiography, with higher HALP scores linked to lower risks of all these outcomes.

Key Findings

Results

CA-AKI occurred in 12.1% of patients undergoing coronary angiography in this large multicenter cohort.

  • Total study population was 42,554 patients undergoing CAG, including those receiving concomitant percutaneous coronary intervention (PCI).
  • 5,130 patients (12.1%) experienced CA-AKI.
  • This was a retrospective observational study with patients stratified according to quartiles of the HALP score.
  • The study design was multicenter.
Results

Higher HALP score was independently associated with significantly lower risk of contrast-associated acute kidney injury.

  • HALP score showed a significant inverse association with CA-AKI, with lower HALP score linked to higher CA-AKI risk.
  • After adjusting for all potential confounding variables, participants in the highest quartile of HALP score had the lowest risk of CA-AKI (OR = 0.81, 95% CI: 0.73–0.90, p < 0.001).
  • Multivariate logistic regression analysis was used to assess the association between HALP score and CA-AKI.
  • The HALP score incorporates hemoglobin, albumin, lymphocyte, and platelet values as a composite nutritional and inflammatory index.
Results

Patients with the highest HALP score quartile had significantly lower all-cause mortality risk.

  • In Cox regression models, patients in the highest HALP score quartile exhibited the lowest risk of all-cause mortality (HR = 0.65, 95% CI: 0.60–0.70, p < 0.001).
  • This represents a 35% relative reduction in all-cause mortality risk for the highest versus lowest HALP quartile.
  • Cox regression models were used to evaluate the relationship between HALP score and mortality outcomes.
Results

Patients with the highest HALP score quartile had significantly lower cardiovascular mortality risk.

  • Patients in the highest HALP score quartile exhibited the lowest risk of cardiovascular mortality (HR = 0.65, 95% CI: 0.58–0.73, p < 0.001).
  • The magnitude of association for cardiovascular mortality was identical to that seen for all-cause mortality (HR = 0.65).
  • Both all-cause and cardiovascular mortality associations were evaluated using Cox regression models adjusted for potential confounders.
Conclusions

The HALP score was independently associated with CA-AKI, all-cause mortality, and cardiovascular mortality as a composite finding.

  • The study aimed to explore relationships between the HALP score and CA-AKI risk, as well as all-cause and cardiovascular mortality in patients undergoing CAG.
  • Associations persisted after adjusting for all potential confounding variables in both logistic and Cox regression models.
  • The HALP score integrates hemoglobin, albumin, lymphocyte, and platelet values, reflecting both nutritional status and systemic inflammation.
  • CA-AKI is described as 'a frequent complication in patients undergoing coronary angiography' that 'can cause deterioration of renal function and adverse clinical outcomes.'

What This Means

This research suggests that a simple blood-based score called the HALP score — calculated from hemoglobin, albumin, lymphocyte, and platelet levels — can predict the risk of kidney injury caused by contrast dye used during heart artery imaging procedures (coronary angiography), as well as the risk of death afterward. In a large study of over 42,000 patients across multiple hospitals, roughly 1 in 8 patients developed contrast-associated acute kidney injury (CA-AKI). Patients with the lowest HALP scores were at greatest risk of developing this kidney complication, while those with the highest scores had about a 19% lower odds of CA-AKI even after accounting for other health factors. The study also found that the HALP score predicted longer-term survival. Patients in the top quarter of HALP scores had about a 35% lower risk of dying from any cause and a 35% lower risk of dying from cardiovascular causes compared to those in the bottom quarter. The HALP score reflects a combination of nutritional status and immune system function, meaning patients who are better nourished and have less systemic inflammation appear to fare better after these procedures. This research suggests that routinely measuring the HALP score before coronary angiography — using blood tests that are already commonly ordered — could help clinicians identify patients who are at higher risk for kidney complications and death, potentially allowing for earlier preventive measures. Because the score is derived from standard laboratory values, it may offer a practical, low-cost tool for risk stratification in cardiology settings.

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Citation

Yang X, Zhu J, Chen Z, Huang D, Chen J, Zhang G, et al.. (2026). Association of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score with Contrast-Associated Acute Kidney Injury and Mortality in Patients Underwent Coronary Angiography: A Multicenter Retrospective Cohort Study.. Vascular health and risk management. https://doi.org/10.2147/VHRM.S634088