Association between the NAPLES score and malignant ventricular arrhythmias in cardiomyopathy patients

Background Malignant ventricular arrhythmias are a major cause of sudden cardiac death in patients with cardiomyopathy. Traditional risk markers, including left ventricular ejection fraction, have limited ability to identify high-risk individuals.Objective To investigate the association between the Naples Prognostic Score (NAPLES), a marker of inflammatory and nutritional status, and malignant ventricular arrhythmias in patients with cardiomyopathy and cardiac implantable electronic devices (CIEDs).Methods This retrospective study included 299 patients with cardiomyopathy and CIEDs. The NAPLES score was calculated using serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Patients were classified into low (0–1) and high (2–4) NAPLES groups. Independent predictors were evaluated using multivariable logistic regression analysis.Results Malignant ventricular arrhythmias were more common in patients with high NAPLES scores than in those with low scores (46.3% vs. 36.1%, p = 0.042). High NAPLES score was independently associated with malignant ventricular arrhythmias (OR: 2.00, 95% CI: 1.14–3.23, p = 0.027). Each one-point increase in NAPLES score was also associated with increased arrhythmic risk (OR: 1.40, 95% CI: 1.08–1.81, p = 0.018).Conclusion The NAPLES score is independently associated with malignant ventricular arrhythmias and may aid arrhythmic risk stratification in patients with cardiomyopathy and CIEDs.