Prognostic impact of Naples prognostic score on long-term mortality in non-ST-elevation myocardial infarction.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Biomarkers in medicine Pub Date : 2025-09-01 Epub Date: 2025-08-15 DOI:10.1080/17520363.2025.2548759

Berhan Keskin, Aykun Hakgor, Fatih Erkam Olgun, Ahmet Berk Duman, Beytullah Cakal, Seda Tanyeri, Barkın Kultursay, Canan Elif Yildiz, Emir Dervis, Ibrahim Oguz Karaca, Bilal Boztosun

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引用次数: 0

Abstract

Background: The Naples Prognostic Score (NPS) is a composite index of inflammation and nutritional status. This study aimed to evaluate the prognostic value of NPS for long-term all-cause mortality in non-ST-elevation myocardial infarction (NSTEMI).

Methods: In this study, 396 consecutive NSTEMI patients who underwent coronary angiography/percutaneous coronary intervention between 1 August 2023, and 31 July 2024, were included. Patients were stratified into low (NPS: 0-1), intermediate (NPS: 2), and high (NPS: 3-4) risk groups. Median follow-up was 433 days. Univariate logistic regression identified predictors of longterm mortality. These were then entered into LASSOpenalized logistic regression for variable selection. Multivariate Cox proportional hazards models assessed the independent predictors of long-term mortality, adjusting for SYNTAX score, hemoglobin, sodium, age, and left ventricular ejection fraction (LVEF).

Results: High-risk NPS patients (n = 91) had higher long-term mortality (17.6%) compared with intermediate-risk (3.7%) and low-risk (3.5%) groups (p < 0.001). In the adjusted Cox model, high-risk NPS independently predicted long-term mortality (HR:3.79; 95% CI 1.55-9.27; p = 0.003), whereas neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were not significant when substituted for NPS.

Conclusion: In NSTEMI patients, NPS independently predicts long-term all-cause mortality beyond traditional risk markers and outperforms isolated inflammatory indices such as NLR and CRP.

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那不勒斯预后评分对非st段抬高型心肌梗死长期死亡率的影响。

背景：那不勒斯预后评分（NPS）是炎症和营养状况的综合指数。本研究旨在评估NPS对非st段抬高型心肌梗死（NSTEMI）长期全因死亡率的预后价值。方法：本研究纳入了396例在2023年8月1日至2024年7月31日期间连续接受冠状动脉造影/经皮冠状动脉介入治疗的NSTEMI患者。患者被分为低（NPS: 0-1）、中（NPS: 2）和高（NPS: 3-4）风险组。中位随访时间为433天。单变量逻辑回归确定了长期死亡率的预测因素。然后将这些输入到lassopenized逻辑回归中进行变量选择。多变量Cox比例风险模型评估了长期死亡率的独立预测因子，调整了SYNTAX评分、血红蛋白、钠、年龄和左心室射血分数（LVEF）。结果：高风险NPS患者（n = 91）的长期死亡率（17.6%）高于中危组（3.7%）和低危组（3.5%）（p = 0.003），而中性粒细胞与淋巴细胞比率（NLR）和c反应蛋白（CRP）在替代NPS时无显著性差异。结论：在NSTEMI患者中，NPS独立预测长期全因死亡率，优于传统风险指标，优于NLR和CRP等孤立炎症指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomarkers in medicine 医学-医学：研究与实验

CiteScore

3.80

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.