The performance of the NAPLES prognostic score in predicting one-year mortality and major adverse cardiovascular events after transcatheter aortic valve implantation in patients with severe aortic stenosis

Abstract

Background: Existing risk scores for transcatheter aortic valve implantation (TAVI) may not fully capture patient complexity. Combining nutritional and inflammatory markers, the NPS (the NAPLES prognostic score) might improve outcome prediction.

Aims: This study investigated the associations of the NPS with one-year mortality and major adverse cardiovascular events (MACEs) in TAVI patients.

Material and methods: This retrospective analysis included 222 patients with severe aortic stenosis who underwent TAVI. The NPS was calculated based on the serum albümin concentration, cholesterol concentration, lymphocyte/monocyte ratio, and neutrophil/lymphocyte ratio. The patients were subsequently categorized into two groups: the low-NPS group (NPS 0-2) and the high-NPS group (NPS 3-4).

Results: A high NPS was significantly associated with increased one-year mortality (4.8% vs. 23.7%; P <0.001) and MACE rates (7.2% vs. 35.9%; P <0.001). Cox regression analysis demonstrated that a high NPS was an independent predictor of both mortality (HR, 5.94; 95% CI, 2.03-17.37; P = 0.001) and MACEs (HR, 5.09; 95% CI, 2.15-12.02; P <0.001).

Conclusions: The NPS emerged as a potential predictor of long-term mortality and MACEs in TAVI patients. Further validation through larger, multicenter, studies is warranted. This research contributes valuable data on the role of the NPS in TAVI risk stratification.

Keywords: aortic valve stenosis; major adverse cardiac events; mortality; prognostic factors; transcatheter aortic valve ımplantation.