{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:51:30Z","timestamp":1791348690365,"version":"4.3.1"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Acute coronary syndrome (ACS), encompassing unstable angina, NSTEMI, and STEMI, is a major cause of morbidity and mortality worldwide. Novel inflammatory and nutritional biomarkers may provide incremental value for risk stratification beyond conventional predictors. This work sought to determine whether the Pan-Immune-Inflammatory Value (PIV) and the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score could serve as independent prognostic indicators in individuals presenting with acute coronary syndrome. Methods: A retrospective multicenter study included ACS patients hospitalized between January 2020 and May 2024. Demographics, clinical data, and laboratory results were collected. PIV was calculated as follows: neutrophils \u00d7 platelets \u00d7 monocytes\/lymphocytes. HALP score was calculated as follows: hemoglobin \u00d7 albumin \u00d7 lymphocytes\/platelets. Correlations with clinical parameters and mortality prediction were analyzed. Results: A total of 1134 patients (mean age 62 \u00b1 12 years) were included. PIV showed positive correlations with WBC (Rho = 0.574), troponin (Rho = 0.381), and CRP (Rho = 0.295), and negative correlations with HDL (Rho = \u20130.101) and ejection fraction (Rho = \u20130.316) (all p &lt; 0.01). PIV independently predicted mortality with a cut-off \u22651074.2 (AUC = 0.619, sensitivity 45%, specificity 79.9%). HALP score negatively correlated with age, troponin, CRP, and ICU stay, and predicted mortality with a cut-off \u22643.58 (AUC = 0.722, sensitivity 53.8%, specificity 82%). Comparative ROC analysis showed that HALP demonstrated superior discriminative ability for mortality prediction compared with PIV. Conclusions: PIV and HALP score are independent prognostic markers in ACS, reflecting inflammatory burden and nutritional status. Their integration into clinical workflows may enhance risk stratification and support individualized management strategies. Given their simplicity and universal availability, PIV and HALP may serve as practical adjunctive tools to established risk scores, enabling early identification of high-risk ACS patients at the time of admission.<\/jats:p>","DOI":"10.3390\/jcm15041660","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T08:58:21Z","timestamp":1771837101000},"page":"1660","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pan-Immune-Inflammatory Value (PIV) and HALP Score as Independent Prognostic Indicators in Acute Coronary Syndrome Patients"],"prefix":"10.3390","volume":"15","author":[{"given":"Azmi","family":"Eyiol","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beyhekim Training and Research Hospital, 42100 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"Eyiol","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Beyhekim Training and Research Hospital, 42100 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Karamano\u011flu Mehmetbey University, 70100 Karaman, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Sari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kemer State Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1038\/s41569-023-00884-0","article-title":"Global epidemiology of acute coronary syndromes","volume":"20","author":"Timmis","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.ijcard.2022.09.062","article-title":"Higher mortality in acute coronary syndrome patients without standard modifiable risk factors: Results from a global meta-analysis of 1,285,722 patients","volume":"371","author":"Kong","year":"2023","journal-title":"Int. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/S0140-6736(23)00351-3","article-title":"Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): A prospective, open-label, non-inferiority, randomised trial","volume":"401","author":"Diletti","year":"2023","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Theofilis, P., Oikonomou, E., Chasikidis, C., Tsioufis, K., and Tousoulis, D. (2023). Pathophysiology of acute coronary syndromes\u2014Diagnostic and treatment considerations. Life, 13.","DOI":"10.3390\/life13071543"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Guven, D.C., Sahin, T.K., Erul, E., Kilickap, S., Gambichler, T., and Aksoy, S. (2022). The association between the pan-immune-inflammation value and cancer prognosis: A systematic review and meta-analysis. Cancers, 14.","DOI":"10.3390\/cancers14112675"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13872","DOI":"10.1111\/eci.13872","article-title":"Comparison of pan-immune-inflammation value with other inflammation markers of long-term survival after ST-segment elevation myocardial infarction","volume":"53","author":"Murat","year":"2023","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3437","DOI":"10.2147\/JIR.S421491","article-title":"Association of systemic inflammatory response index and pan-immune-inflammation-value with long-term adverse cardiovascular events in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention","volume":"16","author":"Liu","year":"2023","journal-title":"J. Inflamm. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3782","DOI":"10.1093\/eurheartj\/ehz155","article-title":"Oral anticoagulation among atrial fibrillation patients with anaemia: An observational cohort study","volume":"40","author":"Bonde","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e938511","DOI":"10.12659\/MSM.938511","article-title":"Correlation between serum albumin and D-dimer levels in 909 patients with non-valvular atrial fibrillation: A retrospective study from a single center in China","volume":"28","author":"Yuan","year":"2022","journal-title":"Med. Sci. Monit."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"706","DOI":"10.29271\/jcpsp.2022.06.706","article-title":"The efficiency of the HALP score and the modified HALP score in predicting mortality in patients with acute heart failure presenting to the emergency department","volume":"32","author":"Kocaoglu","year":"2022","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zheng, Y., Huang, Y., and Li, H. (2023). Hemoglobin albumin lymphocyte and platelet score and all-cause mortality in coronary heart disease: A retrospective cohort study of NHANES database. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1241217"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/MCA.0000000000001271","article-title":"The prognostic value of HALP score in predicting in-hospital mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention","volume":"34","author":"Karakayali","year":"2023","journal-title":"Coron. Artery Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cetinkaya, Z., Kelesoglu, S., Tuncay, A., Yilmaz, Y., Karaca, Y., Karasu, M., Secen, O., Cinar, A., Harman, M., and Sahin, S. (2024). The role of pan-immuneinflammation value in determining the severity of coronary artery disease in NSTEMI patients. J. Clin. Med., 13.","DOI":"10.3390\/jcm13051295"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.amjcard.2023.10.088","article-title":"Pan-immune-inflammation value is independently correlated to impaired coronary flow after primary percutaneous coronary intervention in patients with St-segment elevation myocardial infarction","volume":"211","author":"Kurtul","year":"2024","journal-title":"Am. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"48","DOI":"10.38053\/acmj.1390868","article-title":"Pan-immune inflammation value as a biomarker in ankylosing spondilitis and associated with disease activity","volume":"6","year":"2024","journal-title":"Anatol. Curr. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1161\/CIRCRESAHA.114.302699","article-title":"Inflammation and its resolution as determinants of acute coronary syndromes","volume":"114","author":"Libby","year":"2014","journal-title":"Circ. Res."},{"key":"ref_17","first-page":"201","article-title":"Inflammation in acute coronary syndromes","volume":"87","author":"Robbins","year":"2001","journal-title":"Acute Coron. Syndr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e728","DOI":"10.1161\/CIRCULATIONAHA.105.601492","article-title":"Inflammation in atherosclerosis: Some thoughts about acute coronary syndromes","volume":"113","author":"Lucas","year":"2006","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.cytogfr.2006.04.003","article-title":"Pro-inflammatory cytokines in acute coronary syndromes: From bench to bedside","volume":"17","author":"Tousoulis","year":"2006","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1080\/00365513.2023.2241131","article-title":"Association between pan-immune-inflammation value and no-reflow in patients with ST elevation myocardial infarction undergoing percutaneous coronary intervention","volume":"83","author":"Hidayet","year":"2023","journal-title":"Scand. J. Clin. Lab. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1001\/jama.284.7.835","article-title":"The TIMI risk score for unstable angina\/non\u2013ST elevation MI: A method for prognostication and therapeutic decision making","volume":"284","author":"Antman","year":"2000","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ahj.2004.06.003","article-title":"Impact of age on management and outcome of acute coronary syndrome: Observations from the Global Registry of Acute Coronary Events (GRACE)","volume":"149","author":"Avezum","year":"2005","journal-title":"Am. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.ahj.2005.03.039","article-title":"Age-related differences in the management and outcome of patients with acute coronary syndromes","volume":"151","author":"Yan","year":"2006","journal-title":"Am. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1002\/ehf2.14662","article-title":"Association between hemoglobin, albumin, lymphocytes, and platelets and mortality in patients with heart failure","volume":"11","author":"Liu","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Pan, H., and Lin, S. (2023). Association of hemoglobin, albumin, lymphocyte, and platelet score with risk of cerebrovascular, cardiovascular, and all-cause mortality in the general population: Results from the NHANES 1999\u20132018. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1173399"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e39643","DOI":"10.1097\/MD.0000000000039643","article-title":"The relationship of pan-immune-inflammation value (PIV) and HALP score with prognosis in patients with atrial fibrillation","volume":"103","author":"Eyiol","year":"2024","journal-title":"Medicine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e44460","DOI":"10.1097\/MD.0000000000044460","article-title":"Association of the Pan-Immune-Inflammatory Value (PIV) and HALP score with disease prognosis and recovery in patients with acute pericarditis: An observational cohort study","volume":"104","author":"Eyiol","year":"2025","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1186\/s12933-025-02837-y","article-title":"Impact of glucometabolic status on type 4a myocardial infarction in patients with non-ST-segment elevation myocardial infarction: The role of stress hyperglycemia ratio","volume":"24","author":"Armillotta","year":"2025","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e15854","DOI":"10.1111\/echo.15854","article-title":"Clinical impact of multimodality assessment of myocardial viability","volume":"41","author":"Canton","year":"2024","journal-title":"Echocardiography"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/4\/1660\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T09:21:27Z","timestamp":1771838487000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/4\/1660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,22]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15041660"],"URL":"https:\/\/doi.org\/10.3390\/jcm15041660","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,22]]}}}