The new score predicts 1-year poor outcome in patients with successful percutaneous coronary intervention: Naples prognostic score

Year 2023, , 416 - 420, 27.10.2023

Alkame Akgümüş , Ahmet Balun

https://doi.org/10.38053/acmj.1342844

Abstract

Aims: This study investigated the relationship between Naples prognostic score (NPS) and 1-year poor clinical outcomes in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI).
Methods: The study included 121 patients who had NSTEMI and received successful PCI treatment. The researchers calculated NPS using the neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, serum albumin level, and total cholesterol. The patients were divided into two groups based on their NPS scores: those with scores of 0.1 and 2 and those with scores of 3 and 4. The study compared the occurrence of major cardiovascular events (MACE) such as 1-year all-cause mortality, 1-year nonfatal recurrent MI, and stroke between the two groups.
Results: Patients with high NPS scores were observed to have significantly higher all-cause mortality than those with low NPS scores (23.9% vs. 9.3%, p=0.029). When the MACEs of the patients were compared, significantly higher MACE was observed in the high NPS group (39.1% vs. 18.7%, p=0.013).
In multivariate logistic regression analysis, creatinine (OR:4,914, CI 95%: 1.310-18,433, p=0.018) and NPS 3-4 (OR:2.565, CI 95%: 1.093-6.017, p=0.030) were independent predictors of MACE.
Conclusion: Composite MACEs of non-fatal recurrent MI, cerebrovascular accident, and all-cause death were higher at one year in patients with high NPS who underwent successful percutaneous intervention. High NPS is an indicator of MACE.

Keywords

Naples prognostic score, Acute coronary syndrome, Mortality

References

• Libby P, Tabas I, Fredman G, Fisher EA. Inflammation and its resolution as determinants of acute coronary syndromes. Circ Res. 2014;114(12):1867-1879.
• Zhang DP, Mao XF, Wu TT, et al. The fibrinogen-to-albumin ratio is associated with outcomes in patients with coronary artery disease who underwent percutaneous coronary intervention. Clin Appl Thromb Hemost. 2020;26:1076029620933008. 
• Zengin A, Karaca M, Aruaslan E, et al. Performance of neutrophil to lymphocyte ratio for the prediction of long-term morbidity and mortality in coronary slow flow phenomenon patients presented with non-ST segment elevation acute coronary syndrome. J Cardiovasc Thorac Res. 2021;13(2):125-130.
• Oylumlu M, Oylumlu M, Arik B, et al. Monocyte to high-density lipoprotein cholesterol and lymphocyte to monocyte ratios are predictors of in-hospital and long-term mortality in patients with acute coronary syndrome. Int J Clin Pract. 2021;75(5):e13973.
• Zhang S, Wang H, Chen S, et al. Prognostic nutritional index and prognosis of patients with coronary artery disease: A systematic review and meta-analysis. Front Nutr. 2023;10:1114053.
• Wang H, Fang T, Yin X, et al. Prognostic importance of the preoperative New-Naples prognostic score for patients with gastric cancer. Cancer Med. 2023;12(2):1358-1375.
• Şaylık F, Çınar T, Selçuk M, Akbulut T, Hayıroğlu Mİ, Tanboğa İH. Evaluation of naples score for long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology.
• Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol. 2005;15(4):266-271.
• Wang H, Liu Z, Shao J, et al. Immune and Inflammation in Acute Coronary Syndrome: Molecular Mechanisms and Therapeutic Implications. J Immunol Res. 2020;2020.
• Roy D, Quiles J, Avanzas P, Arroyo-Espliguero R, Sinha M, Kaski JC. A comparative study of markers of inflammation for the assessment of cardiovascular risk in patients presenting to the emergency department with acute chest pain suggestive of acute coronary syndrome. Int J Cardiol. 2006;109(3):317-321.
• Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol. 1997;79(6):812-814.
• Ommen SR, Hodge DO, Rodehefer RJ, McGregor CGA, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation. 1998;97(1):19-22.
• Kao DD, Ferrandino RM, Roof SA, et al. Neutrophil-to-lymphocyte ratio as a predictor of surgical outcomes in head and neck cancer. Head Neck. 2023;45(8):1903-1912.
• Gu Z, Liu B, Yu X, et al. Association of blood neutrophil-lymphocyte ratio with short-term prognosis and severity of tuberculosis meningitis patients without HIV infection. BMC Infect Dis. 2023;23(1):449.
• Lim HA, Kang JK, Kim HW, Song H, Lim JY. The neutrophil-to-lymphocyte ratio as a predictor of postoperative outcomes in patients undergoing coronary artery bypass grafting. J Chest Surg. 2023;56(2):99-107.
• Ji Z, Liu G, Guo J, et al. The neutrophil-to-lymphocyte ratio is an important indicator predicting in-hospital death in AMI patients. Front Cardiovasc Med. 2021;8:706852.
• Lu C, Chen Q, Li J, Wang C, Yu L. The prognostic role of lymphocyte to monocyte ratio (LMR) in patients with myelodysplastic neoplasms. Hematology. 2023;28(1):2210929.
• Song Q, Xu SX, Wu JZ, et al. The preoperative platelet to neutrophil ratio and lymphocyte to monocyte ratio are superior prognostic indicators compared with other inflammatory biomarkers in ovarian cancer. Front Immunol. 2023;14:1177403.
• Kose N, Akin F, Yildirim T, Ergun G, Altun I. The association between the lymphocyte-to-monocyte ratio and coronary artery disease severity in patients with stable coronary artery disease. Eur Rev Med Pharmacol Sci. 2019;23(6):2570-2575.
• Yilmaz M, Tenekecioglu E, Arslan B, et al. White blood cell subtypes and neutrophil-lymphocyte ratio in prediction of coronary thrombus formation in non-ST-segment elevated acute coronary syndrome. Clin Appl Thromb Hemost. 2015;21(5):446-452.
• Ishida S, Hashimoto I, Seike T, Abe Y, Nakaya Y, Nakanishi H. Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study. J Med Invest. 2014;61(3-4):361-368.
• Kurtul A, Ocek AH, Murat SN, et al. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology. 2015;66(3):278-285.
• Lapenna D, Ciofani G, Ucchino S, et al. Serum albumin and biomolecular oxidative damage of human atherosclerotic plaques. Clin Biochem. 2010;43(18):1458-1460.
• Arroyo V, García-Martinez R, Salvatella X. Human serum albumin, systemic inflammation, and cirrhosis. J Hepatol. 2014;61(2):396-407.
• Oduncu V, Erkol A, Karabay CY, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24(2):88-94.
• Bae JM, Yang YJ, Li ZM, Ahn YO. Low cholesterol is associated with mortality from cardiovascular diseases: a dynamic cohort study in Korean adults. J Korean Med Sci. 2012;27(1):58-63.
• Bentz MH, Magnette J. Hypocholesterolemie au cours de la phase aigue de la reaction inflammatoire d’origine infectieuse. A propos de 120 cas. Revue de Medecine Interne. 1998;19(3):168-172.
• Galizia G, Lieto E, Auricchio A, 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(12):1273-1284.
• Erdogan A, Genc O, Ozkan E, et al. Impact of naples prognostic score at admission on in-hospital and follow-up outcomes among patients with ST-Segment elevation myocardial infarction. Angiology. 2023. doi:10.1177/00033197231151559
• Birdal O, Pay L, Aksakal E, et al. Naples prognostic score and prediction of left ventricular ejection fraction in STEMI patients. Angiology. 2023. doi:10.1177/00033197231161903
• Karakoyun S, Cagdas M, Celik AI, et al. Predictive value of the naples prognostic score for acute kidney injury in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Angiology. 2023;33197231161922.
• Ozkan E, Erdogan A, Karagoz A, Tanboğa IH. Comparison of systemic immune-inflammation index and naples prognostic score for prediction coronary artery severity patients undergoing coronary computed tomographic angiography. Angiology. doi: 10.1177/00033197231170979