Zhang Xue, Zhang Jing-Kun, Wu Xue, Liu Xing, Liu Tong, Chen Kang-Yin
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
Angiology. 2024 Sep 19:33197241285970. doi: 10.1177/00033197241285970.
The Naples prognostic score (NPS) is a novel multidimensional inflammatory and nutritional assessment system in cancer patients. However, its significance in patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI) remains unclear. The study has a single-center, retrospective design and included 631 patients with CKD who underwent index PCI between 2019 and 2022. All participants were divided into 2 groups according to the NPS (Low-risk group: = 209; High-risk group: = 422) and followed up until November 2022. The primary endpoint was Major Adverse Cardiac Events (MACE). NPS predicted MACE events better than other scores, besides, high-risk NPS with severe renal dysfunction (RD) group (MODEL 2) had superior MACE diagnostic efficiency than NPS high-risk group lonely. (NPS: AUC: 0.605, < .001; MODEL 2: AUC: 0.624, < .001, respectively). Kaplan-Meier survival analysis of two groups showed that high-risk group had higher incidence of MACE ( < .001). Meanwhile, high-risk group had higher MACE events [adjusted Hazard Ratio (aHR) 2.013, 95% CI 1.294, 3.132; = .002]. NPS is an independent prognostic factor for CKD patients undergoing index PCI before operation whose predictive value for survival prognosis is better than other nutritional and inflammatory indicators. Compared with low NPS, patients with high NPS have a relatively poor prognosis.
那不勒斯预后评分(NPS)是一种针对癌症患者的新型多维炎症和营养评估系统。然而,其在经皮冠状动脉介入治疗(PCI)后慢性肾脏病(CKD)患者中的意义仍不明确。本研究采用单中心回顾性设计,纳入了2019年至2022年间接受首次PCI的631例CKD患者。所有参与者根据NPS分为两组(低风险组:=209;高风险组:=422),并随访至2022年11月。主要终点是主要不良心脏事件(MACE)。NPS对MACE事件的预测优于其他评分,此外,高风险NPS合并严重肾功能不全(RD)组(模型2)的MACE诊断效率优于单纯NPS高风险组。(NPS:AUC:0.605,<.001;模型2:AUC:0.624,<.001)。两组的Kaplan-Meier生存分析表明,高风险组的MACE发生率更高(<.001)。同时,高风险组的MACE事件更多[调整后风险比(aHR)2.013,95%置信区间1.294,3.132;=.002]。NPS是接受首次PCI的CKD患者术前的独立预后因素,其对生存预后的预测价值优于其他营养和炎症指标。与低NPS患者相比,高NPS患者的预后相对较差。