Prognostic Value of the Naples Prognostic Score for Predicting Major Adverse Cardiac Events and Long-Term Outcomes in Patients with NSTEMI

Abstract

Objectives: The Naples prognostic score (NPS) is determined using four parameters: Serum albumin, total cholesterol, the neutrophil-to-lymphocyte ratio, and the lymphocyte-to-monocyte ratio. Since both inflammation and nutritional status have a critical impact on the onset and advancement of cardiovascular diseases, this score has been suggested as a beneficial prognostic tool. In this research, we sought to assess the predictive value of NPS, measured at the time of hospital admission, for major adverse cardiac events (MACE) and long-term outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Patients and methods: A cohort of 125 individuals with NSTEMI, identified between January 1 and June 1, 2019, was retrospectively evaluated. According to their NPS values, the cohort was stratified into two groups: Low NPS (0-2 points; n=73) and high NPS (3,4 points; n=52). Over an average follow-up period of 60 months, the manifestation of MACE and overall mortality was systematically documented. Results: MACE was observed in 31 patients, with a markedly greater frequency in the high-NPS group (n=22; p<0.001). Long-term mortality occurred in 18 individuals, of whom 15 belonged to the high-NPS category (p<0.001). ROC curve analysis determined an optimal NPS threshold of 2.5 for predicting both MACE and overall mortality. Survival analysis using the Kaplan-Meier method revealed a considerable decrease in survival among patients with elevated NPS (p<0.001). Conclusion: The NPS, which incorporates inflammatory and nutritional components, functions as a prognostic determinant of MACE and long-term mortality in NSTEMI cases.