Clinical Significance of the Naples Prognostic Score in Patients with Coronary Artery Ectasia: A Novel Biomarker of Inflammation and Nutrition

INTRODUCTION: Coronary artery ectasia (CAE) is an abnormal dilatation of coronary arteries associated with ischemic complications and thrombotic events. Systemic inflammation and impaired nutritional status are believed to play a pivotal role in its pathogenesis. The Naples Prognostic Score (NPS), a composite marker of inflammation and nutrition, has been associated with adverse cardiovascular outcomes. This study aimed to evaluate the relationship between NPS and the presence of CAE.
METHODS: We retrospectively analyzed 139 patients who underwent coronary angiography between May 2023 and February 2026. Patients were classified into CAE (n=26) and control (n=113) groups. NPS was calculated based on serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Univariable and multivariable logistic regression analyses were performed to identify predictors of CAE. Receiver operating characteristic (ROC) analysis assessed the discriminatory ability of NPS.
RESULTS: Patients with CAE exhibited significantly higher NPS values compared to controls (2.15 ± 1.4 vs. 1.42 ± 0.9; p=0.025). Multivariable analysis demonstrated that NPS was an independent predictor of CAE (OR: 2.018, 95% CI: 1.301–3.129, p=0.002). ROC analysis revealed good discriminatory performance for NPS (AUC: 0.759, p<0.001).
DISCUSSION AND CONCLUSION: Higher NPS values are independently associated with the presence of CAE. NPS may serve as a simple, accessible biomarker reflecting systemic inflammation and malnutrition, providing additional risk stratification in patients undergoing coronary evaluation.

Keywords: Coronary artery ectasia, Naples Prognostic Score, Systemic inflammation, Nutritional status, Coronary angiography, Biomarkers