Prognostic value of the hemoglobin–albumin– lymphocyte–platelet (HALP) score for long-term mortality after transcatheter aortic valve implantation

Introduction: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for severe aortic stenosis in elderly and high-risk patients; however, long-term mortality remains substantial.Conventional surgical risk scores show limited prognostic performance in this population, in whom frailty and impaired nutritional and inflammatory status are common.The hemoglobinalbumin-lymphocyte-platelet (HALP) score integrates these domains, but its prognostic value in TAVI has not been established.Aim: To evaluate whether the preprocedural HALP score predicts long-term all-cause mortality after TAVI.Material and methods: This retrospective single-center study included 785 consecutive patients who underwent TAVI between January 2018 and January 2024.HALP scores were calculated from routine laboratory parameters.Clinical, echocardiographic, and procedural data were collected.Independent predictors of mortality were assessed using Cox regression analysis.The optimal HALP cut-off was determined by maximally selected rank statistics, and survival was analyzed using Kaplan-Meier analysis.Results: During a median follow-up of 21.8 months, 62 (8%) patients died.Non-survivors had significantly lower HALP scores and a higher prevalence of chronic kidney disease and atrial fibrillation.In multivariable analysis, lower HALP scores independently predicted mortality (HR = 0.94; 95% CI: 0.91-0.98;p = 0.002), along with chronic kidney disease and paradoxical low-flow, low-gradient aortic stenosis.A HALP cut-off of 36.82 effectively discriminated long-term survival (log-rank p < 0.0001).Conclusions: Preprocedural HALP score is an independent predictor of long-term mortality after TAVI and may aid preprocedural risk stratification.Key words: transcatheter aortic valve implantation, aortic stenosis, hemoglobin-albumin-lymphocyte-platelet score, inflammation and nutrition, long-term mortality. S u m m a r yRisk stratification after transcatheter aortic valve implantation (TAVI) remains challenging because conventional surgical risk scores do not fully capture frailty, nutritional status, and systemic inflammation.In this single-center cohort of 785 patients, a lower preprocedural hemoglobin-albumin-lymphocyte-platelet (HALP) score was independently associated with increased long-term all-cause mortality after TAVI.A HALP cut-off value of 36.82 effectively discriminated long-term survival.These findings suggest that the HALP score may provide complementary prognostic information and help refine preprocedural risk assessment in patients undergoing TAVI.