Karaduman Ahmet, Yılmaz Cemalettin, Tiryaki Muhammet Mucahit, Balaban İsmail, Keten Mustafa Ferhat, Unkun Tuba, İzci Servet, Efe Suleyman Çağan, Alizade Elnur
Department of Cardiology, Kartal Kosuyolu Research and Education Hospital, Istanbul - Turquia.
Department of Cardiology, Mus State Hospital, Mus - Turquia.
Arq Bras Cardiol. 2025 Apr;122(5):e20240519. doi: 10.36660/abc.20240519.
Saphenous vein graft (SVG) patency remains a challenge in cases of coronary artery disease following coronary artery bypass grafting (CABG) surgery. The Naples prognostic score (NPS) constitutes a novel scoring system designed to assess both nutritional status and inflammation.
Our study aimed to explore the association between the NPS and SVG disease in patients with a previous history of CABG surgery.
A total of 702 patients who had undergone CABG surgery and underwent coronary angiography were reviewed retrospectively. SVG disease was defined as the presence of ≥50% stenosis in at least one SVG. Patients were categorized into two groups based on the presence or absence of SVG disease. Values of p<0.05 were accepted as statistically significant.
The study population consisted of 702 patients, with 269 (38.3%) having degenerative SVGs and 433 (61.7%) without degenerative SVGs. The NPS was higher in the group with saphenous vein degeneration and emerged as a significant predictor of SVG disease (OR: 1.596, 95% CI: 1.198-2.125, p=0.001). Additionally, hypertension (OR: 2.344, 95% CI: 1.137-4.833, p=0.02), chronic kidney disease (OR: 3.337, 95% CI: 1.554-7.168, p=0.002), statin usage (OR: 0.434, 95% CI: 0.239-0.789, p=0.006), time interval since CABG (OR: 1.138, 95% CI: 1.213-1.432, p<0.001), and number of SVGs (OR: 2.708, 95% CI: 1.902-3.855, p<0.001) were significant predictors of SVG disease.
The NPS, a useful tool for assessing inflammation and nutritional status, could provide valuable information about the patency of SVGs following CABG surgery. Patients with elevated NPS after CABG should undergo careful monitoring for the development of SVG disease.
在冠状动脉旁路移植术（CABG）后，大隐静脉移植物（SVG）的通畅性在冠状动脉疾病病例中仍然是一个挑战。那不勒斯预后评分（NPS）是一种旨在评估营养状况和炎症的新型评分系统。
我们的研究旨在探讨既往有CABG手术史的患者中NPS与SVG疾病之间的关联。
回顾性分析了702例行CABG手术并接受冠状动脉造影的患者。SVG疾病定义为至少一支SVG存在≥50%的狭窄。根据是否存在SVG疾病将患者分为两组。p<0.05的值被认为具有统计学意义。
研究人群包括702例患者，其中269例（38.3%）有退行性SVG，433例（61.7%）无退行性SVG。大隐静脉退变组的NPS较高，并且是SVG疾病的显著预测因素（OR：1.596，95%CI：1.198-2.125，p=0.001）。此外，高血压（OR：2.344，95%CI：1.137-4.833，p=0.02）、慢性肾脏病（OR：3.337，95%CI：1.554-7.168，p=0.002）、他汀类药物使用（OR：0.434，95%CI：0.239-0.789，p=0.006）、CABG术后的时间间隔（OR：1.138，95%CI：1.213-1.432，p<0.001）以及SVG的数量（OR：2.708，95%CI：1.902-3.855，p<0.001）是SVG疾病的显著预测因素。
NPS作为评估炎症和营养状况的有用工具，可为CABG术后SVG的通畅性提供有价值的信息。CABG术后NPS升高的患者应密切监测SVG疾病的发生。
