The prognostic importance of the Naples prognostic score for in-hospital mortality in patients with ST-segment elevation myocardial infarction

Coron Artery Dis. 2024 Jan 1;35(1):31-37. doi: 10.1097/MCA.0000000000001285. Epub 2023 Nov 2.

Abstract

Background: The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. However, the prognostic significance of NPS is unknown in ST-segment elevation myocardial infarction (STEMI). We aimed to analyze the prognostic value of the NPS in-hospital mortality in patients with STEMI.

Methods: The study consisted of 3828 patients diagnosed with STEMI who underwent primer percutaneous coronary intervention. As the primary outcome, in-hospital mortality was defined as all-cause deaths during hospitalization. The included patients were categorized into three groups based on NPS (group 1:NPS = 0,1,2; group 2:NPS = 3; group 3:NPS = 4).

Results: Increased NPS was associated with higher in-hospital mortality rates( P < 0.001). In the multivariable logistic regression analysis, the relationship between NPS and in-hospital mortality continued after adjustment for age, male sex, diabetes, hypertension, Killip score, SBP, heart rate, left ventricular ejection fraction, myocardial infarction type and postprocedural no-reflow. A strong positive association was found between in-hospital mortality and NPS by multivariable logistic regression analysis [NPS 0-1-2 as a reference, OR = 1.73 (95% CI, 1.04-2.90) for NPS 3, OR = 2.83 (95% CI, 1.76-4.54) for NPS 4].

Conclusion: The present study demonstrates that the NPS could independently predict in-hospital mortality in STEMI. Prospective studies will be necessary to confirm the performance, clinical applicability and practicality of the NPS for in-hospital mortality in STEMI.

MeSH terms

  • Hospital Mortality
  • Humans
  • Male
  • Myocardial Infarction*
  • Percutaneous Coronary Intervention*
  • Prognosis
  • Prospective Studies
  • ST Elevation Myocardial Infarction* / complications
  • ST Elevation Myocardial Infarction* / diagnosis
  • ST Elevation Myocardial Infarction* / therapy
  • Stroke Volume
  • Ventricular Function, Left