Scopus
🔓 Açık Erişim
The Naples Prognostic Score May Predict No Reflow in Patients Undergoing Percutaneous Coronary Intervention for Saphenous Vein Graft Stenosis
Diagnostics · Mart 2026
Makale Bilgileri
DergiDiagnostics
Yayın TarihiMart 2026
Cilt / Sayfa16
Scopus ID2-s2.0-105032657318
Erişim🔓 Açık Erişim
Özet
Background/Objectives: No-reflow phenomenon (NRP) is a frequent and clinically relevant complication during percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs). The Naples Prognostic Score (NPS), a composite index reflecting systemic inflammation and nutritional status, may help identify patients at increased risk before the procedure. We investigated whether NPS predicts NRP in patients undergoing PCI/percutaneous transluminal coronary angioplasty (PTCA) for SVG stenosis. Methods: In this retrospective multicenter observational study, consecutive post-coronary artery bypass grafting patients undergoing PCI/PTCA for SVG stenosis were analyzed. NRP was defined as post-procedural thrombolysis in myocardial infarction (TIMI) flow grade <3 in the absence of dissection, residual stenosis, or vasospasm. NPS (0–4) was calculated from serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Independent predictors of NRP were assessed using logistic regression, and discrimination was evaluated by receiver operating characteristic (ROC) analysis. Results: Among 252 patients, 55 (21.8%) developed NRP. NPS was significantly higher in the NRP group than in the normal-reflow group (2.61 ± 0.95 vs. 1.73 ± 0.95; p < 0.001). In multivariable analysis, NPS independently predicted NRP (per 1-point increase: odds ratio 2.577, 95% CI 1.428–5.384; p < 0.001 for univariate and 6.077, 95% CI 3.194–11.563; p < 0.001 for multivariate analysis), together with high thrombus burden (TIMI thrombus grades 4–5). NPS showed good discrimination for NRP (AUC 0.742; p < 0.001), with 75% sensitivity and 66% specificity at the optimal cut-off. Conclusions: NPS is a simple, readily available score that independently predicts angiographic no-reflow during SVG PCI and may aid preprocedural risk stratification and tailoring of preventive strategies.
Yazarlar (9)
1
Kadri Murat Gurses
2
Hüseyin Tezcan
3
Mustafa Bilal Ozbay
ORCID: 0000-0003-2760-1028
4
Adnan Karaibrahimoglu
5
Çağrı Yayla
6
Halil Özalp
7
Muhammed Ulvi Yalçın
8
Abdullah Tunçez
9
Yasin Özen
Anahtar Kelimeler
Naples Prognostic Score
no-reflow phenomenon
saphenous vein grafts
thrombolysis in myocardial infarction score
Kurumlar
Ankara City Hospital
Ankara Turkey
Penn Medicine
Philadelphia United States
Selçuk Üniversitesi
Selçuklu Turkey
Süleyman Demirel University, Faculty of Medicine
Isparta Turkey