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January 9, 2023Angiology58 citations

Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction

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AEAslan ErdoğanÖGÖmer GençEÖEyüp Özkan

Key Result

A high Naples prognostic score at admission was an independent predictor of all-cause mortality among STEMI patients (aHR 2.49; 95% CI 1.75-3.50; P<0.001).

Study Design

Type

Cohort (n=1,887)

Structured PICO

Does a high Naples prognostic score at admission predict in-hospital adverse events and all-cause mortality in STEMI patients undergoing primary PCI?

P
Population
1,887 consecutive patients with STEMI who underwent primary percutaneous coronary intervention, followed for a median of 15 months.
E
Exposure
High Naples prognostic score (NPS 3-4) at admission
C
Comparator
Low Naples prognostic score (NPS 0-1-2) at admission
O
Outcome
In-hospital adverse events (acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality) and all-cause mortality during follow-uphard clinical

The Naples prognostic score at admission is an independent predictor of in-hospital adverse events and long-term all-cause mortality in STEMI patients undergoing primary PCI.

Main Result

Hazard Ratio: 2.49 (95% CI 1.75–3.5)

p-value: p=< .001

Abstract

The Naples prognostic score (NPS) consists of cholesterol level, albumin concentration, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratios and reflects systemic inflammation, malnutrition, and survival for various conditions. We investigated the relationship of NPS at admission with in-hospital and follow-up outcomes among ST-segment elevation myocardial infarction (STEMI) patients. This retrospective study included 1887 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention between March 2020 and May 2022. The study population was divided by NPS into 2; low (0-1-2) and high (3-4). In-hospital adverse events and all-cause mortality rates during follow-up were extracted from the registry. The Median follow-up time was 15 months. The overall mortality rate was 14.6%. The proportions of in-hospital events that included acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality were significantly higher in the high NPS group than in the low NPS group. Compared with the baseline model, in the full model of Cox regression analysis; NPS was an independent predictor of all-cause mortality (adjusted hazard ratio (aHR): 2.49, 95%CI, 1.75-3.50, P < .001), with a significant improvement in model performance (likelihood ratio χ 2 , P < .001) and better calibration. In conclusion, we found an association between NPS and in-hospital and follow-up outcomes in STEMI patients.

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Cite This Study

Erdoğan et al. (2023) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,887). High Naples prognostic score (NPS 3-4) vs. Low Naples prognostic score (NPS 0-1-2) was evaluated on All-cause mortality (aHR 2.49, 95% CI 1.75-3.50, p=< .001). A high Naples prognostic score at admission was an independent predictor of all-cause mortality among STEMI patients (aHR 2.49; 95% CI 1.75-3.50; P<0.001).

synapsesocial.com/papers/6aa40a415b75cc9dd9c97859https://doi.org/10.1177/00033197231151559
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