ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1674368
The Brand-New Predictor Index of Fulminant Process in Patients with Acute Myocarditis: Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) score
Provisionally accepted
- Zonguldak Bulent Ecevit Universitesi Tip Fakultesi, Zonguldak, Türkiye
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background/Objectives: Myocarditis can progress to a fulminant form, leading to severe heart failure and mortality. Inflammation and nutritional status play critical roles in disease progression. The haemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel, easily accessible biomarker that reflects both systemic inflammation and nutritional status. This study aimed to evaluate the prognostic value of the HALP score in predicting fulminant myocarditis among patients diagnosed with acute myocarditis. Methods: A total of 124 patients diagnosed with acute myocarditis were retrospectively enrolled in this single-centre study. Patients were categorized into non-fulminant and fulminant myocarditis groups based on diagnostic criteria. Results: The median age of the patients was 24 years, 14.5% was female. Twenty-three of these patients (18.5%) exhibited fulminant myocarditis. Troponin I, C-reactive protein (CRP), white blood cell (WBC), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in the fulminant myocarditis group, while the HALP score was lower (p < 0.001 for all). Multivariable regression analysis identified WBC, NT-proBNP and HALP score as independent predictors of fulminant myocarditis (p = 0.029, p=0.011 and p = 0.046, respectively). The optimal cut-off value of the HALP score was 4.12 for predicting fulminant myocarditis, with an area under the curve of 0.814. Beyond its diagnostic utility, a low HALP score was also significantly associated with worse clinical outcomes. Conclusion: The HALP score can independently predict the development of fulminant myocarditis in acute myocarditis patients.
Keywords: HALP score, Acute myocarditis, Fulminant myocarditis, immunonutrion, biomarker, prognostic
Received: 27 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Aladağ and Avci. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pelin Aladağ, aladagpelin@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.