The Value of Naples Prognostic Score in Predicting Ischemia on Myocardial Perfusion Scintigraphy
Tuba Unkun1
, Serdar Fidan1, Sevim Türkday Derebey2, Büşra Güvendi Şengör1, Mehmet Aytürk1, Münevver Sarı1, Süleyman Çağan Efe1, Gökhan Alıcı1, Birol Özkan1, Ali Karagöz1
1Department of Cardiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Türkiye
2Department of Cardiology, Samsun Training and Research Hospital, Samsun, Türkiye
Keywords: Myocardial ischemia; myocardial perfusion scintigraphy; naples prognostic score; single-photon emission computed tomography.
Abstract
Objectives: Naples prognostic score (NPS) is a recently established score that measures inflammation and nutritional conditions. This score includes lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, total cholesterol levels, and serum albumin levels. Initial studies have shown that the NPS score has more prognostic value than other inflammatory parameters in some cancer diseases. Recently, the association of the NPS score with various cardiovascular diseases has started to be evaluated. The association between ischemia in myocardial perfusion scanning and the Naples score has not yet been investigated. In this study, we evaluated if the NPS may help predict ischemia in myocardial perfusion scanning.
Methods: This study included a total of 110 patients. All patients underwent myocardial perfusion scintigraphy (MPS) at the nuclear medicine department, with dipyridamole or adenosine administered as the pharmaceutical stressor. The subjects were divided into two groups according to the presence or absence of ischemia on gated single-photon emission computed tomography (SPECT) MPI. Laboratory values within the past month before MPS were obtained from digital records for both groups. The NPS was calculated for each group. Laboratory values and NPSs of the groups were compared.
Results: All individuals in the trial had gated SPECT MPI. The average age of individuals was 59.8±11.1 years, with 62 patients (56%) being male. Subjects were divided into two groups according to the presence or absence of ischemia on gated SPECT MPI. Table 1 displays the demographics of the whole study population. Based on the laboratory data (Table 2), there was no significant difference in the demographic features of the groups. The ischemia group had significantly higher levels of white blood cell count (cells/ μL), neutrophil count (cells/µL), hemoglobin (g/dL), CRP (mg/L), and NPS (8.6±2.2, 7.7±1.9, p=0.040; 5.0±2.1, 4.1±1.3, p=0.014; 12.6±1.7, 13.4±1.8, p=0.025; 8.2±2.0, 7.9±2.0, p=0.004; 2.6±1.0, 1.5). Other laboratory results did not differ across the groups.
Conclusion: Our findings indicated an association between NPS and the detection of ischemia in MPS. NPS is an independent variable for diagnosing myocardial ischemia in stable coronary artery disease patients.
Cite This Article: Unkun T, Fidan S, Türkday Derebey S, Güvendi Şengör B, Aytürk M, Sarı M, et al. The Value of Naples Prognostic Score in Predicting Ischemia on Myocardial Perfusion Scintigraphy. Koşuyolu Heart J 2024;27(2):63–69