Guo Ziyan, Zhang Futao, Chai Shuai
Division of Cardiology, The First Affiliated Hospital of Henan University, 385 Ximen Ave Longting District, Kaifeng 475000, China.
Division of Cardiology, The First Affiliated Hospital of Henan University, 385 Ximen Ave Longting District, Kaifeng 475000, China.
Heart Lung. 2025 Mar-Apr;70:360-367. doi: 10.1016/j.hrtlng.2025.01.009. Epub 2025 Jan 28.
The Naples prognostic score (NPS), a novel nutritional and inflammatory index, holds great promise for predicting the prognosis of heart failure (HF), but research on its association with HF outcomes is limited.
To analyze the relationship between the NPS and the incidence rate and long-term prognosis of HF.
Participants from the National Health and Nutrition Examination Survey (NHANES) data were allocated into three groups (group 0 (the NPS=0), group 1-2 (the NPS=1-2), and group 3-4 (the NPS=3-4)) based on the NPS level. Regression analysis was conducted to examine the relationship between the NPS and HF prevalence, and ROC curve analysis was employed to determine the prediction accuracy. The Cox proportional hazards model and Kaplan-Meier survival curves analyzed mortality risk, with subgroup and sensitivity analyses for model stability.
The study included 47,300 individuals (mean age 47.18 years; 51.07% female; 68.86% non-Hispanic white). The HF prevalence was 2.30% (95% CI: 1.66, 3.17). Among 1,581 HF patients, 851 all-cause deaths occurred during a median follow-up of 6.84 years. In groups 3-4, the risk of all-cause, cardiovascular, and cancer mortality was significantly higher (4.18, 4.89, and 16.93, respectively, all p < 0.05) compared to group 0. Furthermore, a significant difference was observed in the association between the NPS and cancer mortality across age subgroups (p < 0.05). In contrast, there was no significant interaction between the NPS and all-cause mortality or cardiovascular mortality in subgroup analyses.
The NPS is a low-cost and easy-to-calculate prognostic score that helps predict the clinical course of patients with HF.
那不勒斯预后评分(NPS)是一种新型的营养和炎症指标,在预测心力衰竭(HF)预后方面具有很大潜力,但关于其与HF结局关联的研究有限。
分析NPS与HF发病率及长期预后的关系。
根据NPS水平,将来自美国国家健康与营养检查调查(NHANES)数据的参与者分为三组(0组(NPS = 0)、1 - 2组(NPS = 1 - 2)和3 - 4组(NPS = 3 - 4))。进行回归分析以检验NPS与HF患病率之间的关系,并采用ROC曲线分析来确定预测准确性。使用Cox比例风险模型和Kaplan - Meier生存曲线分析死亡风险,并进行亚组分析和敏感性分析以评估模型稳定性。
该研究纳入了47300名个体(平均年龄47.18岁;51.07%为女性;68.86%为非西班牙裔白人)。HF患病率为2.30%(95%CI:1.66,3.17)。在1581例HF患者中,在中位随访6.84年期间发生了851例全因死亡。与0组相比,3 - 4组的全因、心血管和癌症死亡风险显著更高(分别为4.18、4.89和16.93,均p < 0.05)。此外,在各年龄亚组中,NPS与癌症死亡之间的关联存在显著差异(p < 0.05)。相比之下,在亚组分析中,NPS与全因死亡率或心血管死亡率之间没有显著的相互作用。
NPS是一种低成本且易于计算的预后评分,有助于预测HF患者的临床病程。