Key result
High NORPACS risk score linked to ~5-fold higher in-hospital mortality.
Why the study?
Does the NORPACS risk score predict in-hospital and all-cause mortality in patients with STEMI undergoing primary PCI?
Cohort (n=1,725)
Does the NORPACS risk score predict in-hospital and all-cause mortality in patients with STEMI undergoing primary PCI?
Answers are grounded in this paper and cite their sources.
The NORPACS risk score independently predicts both in-hospital and long-term all-cause mortality in STEMI patients treated with primary PCI, offering a practical tool for risk stratification.
Background The no-reflow prediction in acute coronary syndrome (NORPACS) risk score was developed to predict the risk of no reflow after percutaneous coronary intervention (PCI). Objectives This study sought to investigate whether the NORPACS risk score predicts the outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (pPCI). Methods This retrospective study included 1725 patients. Receiver operating characteristic curve analysis revealed 6 as the optimal NORPACS risk score cut-off value. Patients were thus dichotomized into two groups: high (≥ 6) NORPACS risk score (n = 765) and low (< 6) NORPACS risk score (n = 960). Results The frequency of in-hospital and all-cause mortality was significantly higher in the high NORPACS risk score group than in the low NORPACS risk score group. Compared with the baseline model, in the full model of binary logistic regression, the NORPACS risk score as both a continuous and a categorical variable emerged as an independent predictor of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.31–1.99, p < 0.001; OR: 4.96, 95% CI: 2.13–11.54, p < 0.001; respectively). Compared with the baseline model, in the full model of multivariable Cox proportional hazards regression analysis, the NORPACS risk score as both a continuous and a categorical variable emerged as an independent predictor of all-cause mortality (hazard ratio [HR]: 1.22, 95% CI: 1.07–1.38, p = 0.004; HR: 1.97, 95% CI: 1.27–3.06, p = 0.003; respectively). Conclusion The NORPACS risk score can be used for prognostication of patients with STEMI treated with pPCI. It predicts in-hospital and long-term all-cause mortality and may serve as a practical tool for risk stratification in this patient population. Graphic abstract
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Erdoğan et al. (2026) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,725). High NORPACS risk score (≥6) vs. Low NORPACS risk score (<6) was evaluated on In-hospital mortality (OR 4.96, 95% CI 2.13-11.54, p=<0.001). A high NORPACS risk score (≥6) independently predicted both in-hospital mortality (OR 4.96, 95% CI 2.13–11.54, p<0.001) and long-term all-cause mortality (HR 1.97, 95% CI 1.27–3.06, p=0.003).
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