Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography

Abstract

This study compared the predictive power of the systemic immune-inflammation index (SII) and Naples prognostic score (NPS) in determining the severity of coronary artery disease (CAD). The study included 1138 patients who underwent coronary computed tomographic angiography (CCTA). The primary outcome was the evaluation of CAD severity, determined by the Coronary Artery Disease-Reporting and Data System (CAD-RADS) obtained from the CCTA scans. A basic statistical model including age, gender, chest pain, diabetes mellitus, hypertension, hyperlipidemia, and smoking was built, and categorical variables, NPS (Naples 3,4 vs 0,1,2) and SII, were added to the basic statistical model. The net benefits of the predictive parameters were determined by a decision curve analysis, and the association between CAD-RADS and NPS, SII was quantified by odds ratios (OR) and 95% confidence intervals (CI). The decision curve analysis showed that adding SII to the statistical model had a better full range of probability of clinical net benefit compared with the baseline model (OR: 5.77, 95% CI 4.15–8.02, P < .001). However, adding the NPS ( P = .11) to the model did not outperform the basic statistical model. In conclusion, the SII may have a net predictive effect on top of traditional risk factors.

Clinical implication of the Naples prognostic score on transcatheter aortic valve replacement in patients with severe aortic stenosis

“…Moreover, Ozkan et al 19 Major observational studies and randomized controlled trials have identified some independent predictors of in-hospital and longterm mortality for patients with severe AS who underwent TAVR. 1,4,6,17,26 Previously, Lauridsen et al reported that among patients undergoing TAVR, an increasing risk of exacerbation with chronic obstructive pulmonary disease was associated with increasing 1-year mortality compared with non-chronic obstructive pulmonary disease patients.…”

“…8,15,16 Additionally, malnutrition has also been associated with mortality, morbidity, and disease severity in cardiovascular disease. 6,10,13,14,[17][18][19][20][21] Recently, several investigators have reported that malnutrition is a predictor of worse outcomes in patients with severe AS undergoing surgical aortic valve replacement. 14,22 Likewise, Sudo et al have recently shown that patients with low nutritional status were more likely to have right-sided heart overload and exhibited an increased risk of 3-year mortality.…”

“…have compared the NPS with several inflammatory markers in predicting coronary artery severity. They reported that the several inflammatory markers had a better full range of probability of clinical net benefit compared with the baseline model (odds ratio: 5.77, 95%CI: 4.15-8.02, p < 0.001) 19. However, adding the NPS (p = 0.11) to the model did not outperform the basic statistical model.…”