Predictive Value of the Naples Score for InHospital Mortality in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Year 2023, Volume: 26 Issue: 3, 115 - 120, 21.11.2023

Ender Öner Serkan Kahraman

Abstract

Introduction: ST-segment elevation myocardial infarction (STEMI) is a significant contributor to mortality. The identification of high-risk patients holds great importance for prognosis. The development of a scoring system that incorporates both inflammatory and nutritional status components can provide valuable insights into prognosis.

Patients and Methods: This is a retrospective observational study comprising 570 consecutive ST-elevation myocardial infarction patients who underwent primary coronary intervention between 2018 and 2020. Patient data were obtained from the electronic database of the hospital.

Results: The incidence of in-hospital mortality rate was 4.9%. The entire group was then divided into two groups based on the presence of in-hospital mortality: 542 patients without in-hospital mortality constituted group 1, while 28 patients with in-hospital mortality formed group 2. In the multivariate logistic regression analysis, the Naples score was identified as an independent predictor of in-hospital mortality.

Conclusion: A higher Naples score is associated with increased in-hospital mortality in patients with STelevation myocardial infarction who undergo primary coronary intervention.

Keywords

ST-elevation myocardial infarction, inflammation, mortality, risk scores

References

• 1. Zeymer U, Ludman P, Danchin N, Kala P, Laroche C, Sadeghi M, et al. Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: The ACVC-EAPCI EORP STEMI registry of the European society of cardiology. Eur Heart J 2021;42(44):4536-49.
• 2. Ibanez B, James S, Agewell S, Antunes MJ, Ducci CB, Byeno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39:119-77.
• 3. Fox KA, Carruthers KF, Dunbar DR, Graham C, Manning JR, De Raedt H, et al. Underestimated and under-recognized: The late consequences of acute coronary syndrome (GRACE UK-Belgian Study). Eur Heart J 2010;(22):2755-64.
• 4. Lin A, Devlin G, Lee M, Kerr AJ: Performance of the GRACE scores in a New Zealand acute coronary syndrome cohort. Heart 100: 1960-1966, 2014.
• 5. Wong BW, Meredith A, Lin D, Mc Manus BM. The biological role of inflamation in atherosclerosis. Can J Cardiol 2012;28:631-41.
• 6. Galizia G, Lieto E, Auricchio A, Cardella F, Mabilia A, Podzemny V, et al. Naples prognostic score, based on nutritional and inflammatory status, is an independent predictor of long-term outcome in patients undergoing surgery for colorectal cancer. Dis Colon Rectum 2017;60:1273-84.
• 7. Madjid M, Willerson JT. Inflammatory markers in coronary heart disease. Br Med Bull 2011;100:23-38.
• 8. Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and clinical significance. JPEN 2019;43:181-93.
• 9. Şaylık F, Çınar T, Selçuk M, Akbulut T, Hayıroğlu Mİ, Tanboğa İH. Evaluation of Naples score for long-term mortality in patients with STsegment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology 2023:33197231170982.
• 10. Erdoğan A, Genç Ö, Özkan E, Göksu MM, İbişoğlu E, Bilen MN, et al. Impact of Naples prognostic score at admission on in hospital and folllow up outcomes among patients with ST-segment elevation myocardial infarction. Angiology 2023;74:970-80.
• 11. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction. J Am Coll Cardiol 2018;72:2231-64.
• 12. Shah AD, Denaxas S, Nicholas O, Hingorani AD, Hemingway H. Neutrophil counts and initial presentation of 12 cardiovascular diseases: A CALIBER Cohort Study. J Am Coll Cardiol 2017;69(9):1160-9.
• 13. Kurtul A, Yarlioglues M, Murat SN, Ergun G, Duran M, Kasapkara, H et al. Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Am J Cardiol 2014;114:342-7.
• 14. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al; Intermountain Heart Collaborative Study Group. Which white cell subtypes predict increased cardiovascular risk? J Am Cardiol 2005;45:1638- 43.
• 15. Shantsila E, Lip GY. The role of monocytes in thrombotic disorders. Insights from tissue factor, monocytes-platelet aggregates and novel mechanism. Thromb Haemost 2009;102:916-24.
• 16. Tapp LD, Shantsila E, Wrigley BJ, Pamukcu B, Lip GY. The CD 14++ CD+ monocyte subset and monocyte-platelet interactions in patients with ST-elevation myocardial infarction. J Thromb Haemost 2012;10:1231-41.
• 17. Joles JA, Willekes-Koolschijn N, Koomans HA. Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int 1997;52(3):761-70.
• 18. Don BR, Kaysen G. Serum albumin: Relationship to inflammation and nutrition. Semin Dial 20114;17(6):432-7.
• 19. Biccire FG, Pastori D, Tanzilli A, Pignatelli P, Viceconte N, Barilla F, et al. Low serum albumin levels and in-hospital outcomes in patientswith ST segment elevation myocardial infarction. Nutr Metabol Cardiovasc Dis 2021;31:2904-11.
• 20. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary artery disease continuous and graded? Findings in 356,222 primary screnees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1980;256:2823-8.
• 21. Iribarren C, Reed DM, Chen R, Yano K, Dwyer JH. Low serum cholesterol and mortality. Which is the cause and which is the effect? Circulation 1995;92:2396-403.
• 22. Nakagawa N, Yamada S, Sonohara F, Takami H, Hayashi M, Kanda M, et al. Clinical implications of naples prognostic score in patients with resected pancreatic cancer. Ann Surg Oncol 2020;27:887-95.