Prognostic Value of the Naples Score in Older Patients With Acute Coronary Syndrome

The Naples prognostic score (NPS) consists of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), serum albumin levels, and total cholesterol (TC) levels. This study hypothesizes that the NPS may predict mortality in older patients with acute coronary syndrome (ACS). We conducted a retrospective study including 380 patients diagnosed with ACS at our hospital from May 2015 to December 2022. Older hospitalized patients (≥75 years of age) with ACS were divided by NPS into 2 groups: low NPS (0-2) and high NPS (3-4). The median follow-up time was 23 months. The primary outcome was long-term mortality from the day of admission. In-hospital mortality was 15.8% (n = 60 patients), and long-term mortality was 50.5% (n = 192). In the high-NPS group two, a higher rate of long-term mortality was observed (group 2, n = 123 [58%] vs group 1, n = 69 [41.1%], P < .001). In contrast, gender, diabetes mellitus, hypertension, SYNTAX score, or in-hospital mortality were not associated with NPS. In this study, these results demonstrated that high NPS values may be a predictor of all-cause mortality.