Prognostic Value of the Osaka Prognostic Score for One-Year Mortality in Patients with ST-Segment Elevation Myocardial Infarction: A Retrospective Observational Cohort Study

Background/Objectives: The Osaka Prognostic Score (OPS) has demonstrated prognostic value in various cardiovascular settings. However, its role in predicting long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) remains insufficiently explored. This study aimed to investigate the association between baseline OPS and one-year all-cause mortality in patients presenting with STEMI. Methods: OPS was calculated in 463 consecutive patients with STEMI at hospital admission. The primary endpoint was one-year all-cause mortality. Clinical, laboratory, echocardiographic, and angiographic variables were analyzed for each patient. Results: During one-year follow-up, patients who died exhibited significantly higher OPS values compared with survivors (1.70 ± 0.89 vs. 0.38 ± 0.65; p < 0.001). In multivariable logistic regression analysis, lower hemoglobin levels (OR 0.780, 95% CI 0.630–0.967; p < 0.001) and left ventricular ejection fraction (OR 0.948, 95% CI 0.902–0.997; p = 0.037) were associated with an increased risk of mortality whereas both the GRACE risk score (OR 2.653, 95% CI 1.345–3.987; p < 0.001) and OPS (OR 1.536, 95% CI 1.102–2.234; p = 0.001) were positively associated with mortality. The combined GRACE + OPS logistic regression model demonstrated significantly better discriminative performance for predicting 1-year mortality compared with the GRACE-only model (AUC: 0.836 vs. 0.761). DeLong analysis confirmed that the addition of OPS significantly improved predictive accuracy (ΔAUC = 0.075, 95% CI: 0.015–0.136; p = 0.014). Conclusions: Baseline OPS is independently associated with one-year all-cause mortality in patients with STEMI and may have potential utility in this group of patients.