ENGİN ALGÜL, NAİL BURAK ÖZBEYAZ, NADİRE IŞIK EROL ALGÜL
Anatolian Current Medical Journal - 2025;7(4):524-528
Aims: Acute kidney injury (AKI) is a frequent complication in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The Naples prognostic score (NPS), which integrates inflammatory and nutritional markers, may improve identification of patients at higher risk for AKI. This study aimed to evaluate the predictive value of NPS for AKI in ACS patients undergoing PCI. Methods: We retrospectively analyzed 1360 ACS patients treated with PCI. AKI was defined as an increase in serum creatinine ≥0.5 mg/dl or ≥25% from baseline within 48–72 hours after the procedure. NPS was calculated using serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Patients were categorized into low-risk (NPS 0–2) and high-risk (NPS 3–4) groups. Logistic regression and ROC analysis were performed. Results: AKI occurred in 221 patients (16.3%). Patients with AKI were older and had higher rates of diabetes, heart failure (HF), and LAD involvement. In multivariate analysis, high NPS was independently associated with AKI (OR=4.127, 95% CI: 4.008–4.460, p<0.001), along with diabetes and HF. NPS showed good predictive ability (AUC=0.823), outperforming albumin, cholesterol, NLR, and LMR individually. Conclusion: NPS is a simple and effective tool to predict AKI in ACS patients undergoing PCI. It may aid in early risk stratification and guide preventive strategies in clinical practice.
