The Osaka Prognostic Score predicts in-hospital mortality in Non-ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention

Objective Non-ST-segment elevation myocardial infarction (NSTEMI) remains a leading cause of morbidity and mortality worldwide. The Osaka Prognostic Score (OPS), a composite metric reflecting systemic inflammation and nutritional status through C-reactive protein (CRP), albumin, and total lymphocyte count (TLC), has been explored in various clinical settings. This study aimed to investigate the association between OPS and in-hospital mortality among NSTEMI patients undergoing percutaneous coronary intervention (PCI). Patients and Methods A retrospective cohort of 959 NSTEMI patients treated with PCI between September 2022 and November 2024 was analyzed. OPS was calculated by assigning one point each for CRP >10 mg/L, albumin <3.5 g/dL, and TLC <1,600/μL. Patients were categorized into four groups based on their OPS (0-3). The primary endpoint was in-hospital mortality, and multivariate logistic regression analysis was employed to identify independent predictors. Prognostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results Patients with higher OPS scores demonstrated significantly increased in-hospital mortality (OPS 2-3: 12.8% vs. OPS 0-1: 3.6%; p<0.001). Multivariate analysis identified OPS as an independent predictor of mortality (OR: 13.5, 95% CI: 4.11–44.52, p<0.001). ROC curve analysis yielded an area under the curve (AUC) of 0.898 for OPS, with 94% sensitivity and 74% specificity, outperforming other inflammatory and nutritional markers. Conclusions OPS is a robust independent predictor of in-hospital mortality in NSTEMI patients undergoing PCI. Its integration into routine clinical practice could enhance early risk stratification and optimize management strategies for high-risk patients. Further studies are warranted to validate these findings in diverse populations and assess its utility in predicting long-term outcomes.