Predictive Value of the Naples Prognostic Score for One-Year Mortality in NSTEMI Patients Undergoing Selective PCI

Objectives: Non-ST-elevation myocardial infarction (NSTEMI) is a common and severe condition that requires rapid and accurate risk assessment and treatment. The Naples prognostic score (NPS) is a novel risk score that integrates nutritional and inflammatory parameters. The aim of this study was to investigate the NPS as a predictor of one-year mortality in NSTEMI patients undergoing percutaneous coronary intervention (PCI). Methods: This retrospective study included 197 NSTEMI patients who underwent selective PCI from January 2020 to December 2020. The NPS was calculated based on the total cholesterol, serum albumin, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio. Patients were categorized into two groups based on their NPS values: Group 1 (NPS 0-2) and Group 2 (NPS 3 or 4). The one-year mortality status of the patients was determined through phone calls or by querying the national death registry system. Results: During the follow-up period, the overall mortality rate was 19.3% (n = 38). The high NPS group exhibited a significantly higher mortality rate compared to the low NPS group, with rates of 33.7% and 8.1%, respectively (p < 0.001). A Cox regression analysis indicated that a high NPS score is an independent predictor of one-year mortality, with a hazard ratio of 4.52 (95% CI: 1.93-10.58; p < 0.001). Conclusions: The NPS is a simple, cheap, and easily accessible tool that can be used for risk stratification and treatment selection in NSTEMI patients. It also highlights the importance of inflammatory and nutritional status in influencing the prognosis of NSTEMI patients.