Prognostic significance of C-reactive protein-albumin-lymphocyte (CALLY) index after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Long-term prognostic value of CRP-albumin-lymphocyte index in elderly patients with heart failure with preserved ejection fraction

BACKGROUND

Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical condition characterized by the interplay of malnutrition and immune inflammation, especially in elderly patients. The CRP-Albumin-Lymphocyte (CALLY) index, a novel composite indicator reflecting immune inflammation and nutritional status, has not yet been validated as a prognostic tool in elderly patients with HFpEF.

METHODS

This retrospective study included 320 elderly patients hospitalized at the Air Force Medical Center from October 2016 to April 2019 due to HFpEF. Patients were stratified into the all-cause mortality and the survival groups according to follow-up outcomes. Kaplan-Meier analysis and Cox regression were performed to identify risk factors associated with poor prognosis. Additionally, we constructed and evaluated a nomogram based on the CALLY index to predict survival rates.

RESULTS

During the follow-up period, 137 cases (42.81 %) of patients experienced all-cause mortality. Kaplan-Meier survival curves and Cox regression analysis revealed that a lower CALLY index (HR 0.811, 95 % CI 0.714-0.921, P = 0.001) was independently associated with adverse prognosis in elderly patients with HFpEF. The nomogram incorporating the CALLY index exhibited robust predictive performance for predicting 1-year, 3-year, and 5-year survival outcomes.

CONCLUSION

Our findings demonstrate that the CALLY index is an independent predictor of long-term mortality in elderly patients with HFpEF. The developed nomogram incorporating the CALLY index could effectively predict survival probabilities.

Lower CALLY index levels indicate higher poor functional outcome risk in acute ischemic stroke patients treated with endovascular thrombectomy

Background

The imbalance in the nutrition-immunity-inflammation status is linked to the prognosis of various diseases. This study sought to evaluate the correlation between the C-reactive protein-albumin-lymphocyte (CALLY) index and the outcomes of acute ischemic stroke (AIS) managed with endovascular thrombectomy (EVT).

Methods

This study retrospectively enrolled 473 AIS patients who underwent EVT from a multicenter investigation. Poor functional outcome was defined as a modified Rankin scale score exceeding 2 points at 90 days after EVT. The cutoff value for the CALLY index was determined using the receiver operating characteristic curve. Multivariable logistic regression models were utilized to explore the association between the CALLY index and poor functional outcome and restricted cubic splines was used to illustrate the relationship between the CALLY index and the risk of poor functional outcome after EVT.

Results

Poor functional outcomes occurred in 214 (45.2%) patients at 90 days after EVT. The cutoff for the CALLY index was 10^ (-0.635). Multivariate logistic regression revealed that the CALLY index was significantly associated with poor functional outcome (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.70-0.91, p < 0.001; high versus low OR: 0.64, 95% CI: 0.41-1.00, p = 0.048). The restricted cubic spline analysis indicated an inverse association between the CALLY index and the risk of poor functional outcome (P for nonlinearity = 0.373).

Conclusion

Our study identified that a lower CALLY index is an independent predictor of poor functional outcome after EVT. The CALLY index could emerge as a practical, cost-effective, and promising predictive biomarker for adverse outcomes in AIS patients undergoing EVT treatment.

A novel indicator of all-cause mortality in acute coronary syndrome: the CALLY index

AIMS

This study aimed to identify the prognostic significance of the C-reactive protein-albumin-lymphocyte (CALLY) index for predicting all-cause mortality in acute coronary syndrome (ACS) patients who have undergone primary percutaneous coronary intervention (pPCI) for revascularization.

MATERIALS AND METHODS

505 patients who presented with ACS and underwent pPCI were retrospectively included in this single center study. CALLY index and other five prognostic scores were calculated. The median follow-up was 40 months. All-cause mortality was defined as the primary endpoint.

RESULTS

The median age of the patients was 59 years, 23.4% were female. The CALLY index was categorized into low (<0.7) and high (≥0.7). Age (p = 0.038), concomitant atrial fibrillation (p = 0.023), previous CABG (p = 0.001), ACE-I/ARB/ARNI use (p = 0.015), diuretic use (p = 0.021), and a low-CALLY index (p < 0.001) were identified as independent predictors of all-cause mortality in multivariate cox regression analysis. When compared to other prognostic scores according to AUC in ROC analysis, the CALLY index demonstrated the best ability to predict all-cause mortality. Additionally, patients with a high-CALLY index exhibited significantly better survival outcomes compared to those with a low-CALLY index (log-rank:p < 0.001).

CONCLUSIONS

CALLY index can be utilized as a novel prognostic score for predicting all-cause mortality in ACS patients who have undergone pPCI.

Novel indicator for erectile dysfunction: the CALLY index, evidence from data of NHANES 2001-2004

Purpose

This study explored the association between the C-reactive protein-albumin-lymphocyte (CALLY) index and erectile dysfunction (ED).

Patients and methods

Data from 2,128 participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed and classified into ED and non-ED groups.Additionally, a separate analysis of complete erectile dysfunction was conducted.A weighted multiple logistic regression model was used to assess the association between CALLY and ED, while smooth curve fitting was applied to explore their linear relationship.ROC analysis was conducted to compare the predictive accuracy (AUC) of CALLY, Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), Aggregate Index of Systemic Inflammation (AISI), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and the product of platelet count and neutrophil count (PPN) for ED.

Results

After adjustment, Ln-CALLY was negatively associated with ED (OR = 0.77, 95% CI: 0.69-0.85, p < 0.0001) and complete ED (OR = 0.88, 95% CI: 0.78-1.00, p = 0.0450).The highest Ln-CALLY tertile (Q3) was associated with a significantly lower risk of ED compared to Q1 (OR = 0.40, 95% CI: 0.30-0.55, p < 0.0001).A similar trend was observed for complete ED (OR = 0.57, 95% CI: 0.38-0.85, p = 0.006).Curve fitting revealed a negative correlation between CALLY and both types of ED.Subgroup analysis confirmed the consistent and independent association.CALLY exhibited superior predictive performance for ED (AUC = 0.6512) and complete ED (AUC = 0.6237) compared to other markers.

Conclusion

Higher CALLY levels were linked to a reduced ED risk and proved a superior predictor compared to other inflammatory markers.

Inverse association between CALLY index and angina pectoris in US adults: a population-based study

BACKGROUND

The C-reactive protein-albumin-lymphocyte (CALLY) index is a significant marker that reflects both inflammatory and nutritional states and has proven to be a valuable tool for assessing prognosis in various medical conditions. However, the connection between it and angina pectoris has not yet been fully examined. This research sought to thoroughly investigate the possible link between the CALLY index and angina pectoris.

METHODS

This research utilized a cross-sectional approach, drawing data from the 2003-2010 National Health and Nutrition Examination Survey (NHANES), which included 16,291 adults from the U.S. The CALLY index was calculated based on lymphocyte counts, serum albumin concentrations, and C-reactive protein (CRP) levels. The relationship between the CALLY index and angina pectoris was analyzed using multivariate logistic regression and restricted cubic spline (RCS) methods. Subgroup and interaction analyses were also performed.

RESULTS

Elevated ln CALLY was inversely correlated with the prevalence of angina (OR: 0.88, 95% CI: 0.82, 0.95). Those in the highest quartile of the ln CALLY (Q4) were 38% less likely to experience angina than those in the lowest quartile (Q1) (OR: 0.62, 95% CI: 0.46, 0.84). RCS analysis revealed an L-shaped curve linking the CALLY index to angina, with a cutoff at 14. The consistency of this relationship was substantiated through subgroup analyses across different population groups.

CONCLUSIONS

This research highlights a notable inverse relationship between the CALLY index and angina in U.S. adults, suggesting its potential as an innovative tool for evaluating angina.

Predictive Value of Albumin to Fibrinogen Ratio and CALLY Index for Diagnosis of Ulcerative Colitis and Mucosal Healing After Vedolizumab Treatment

Purpose

The albumin to fibrinogen ratio (AFR), a biomarker associated with inflammatory, nutritional, and coagulation status, and the CALLY index, a biomarker combining C-reactive protein, albumin, and lymphocyte count, have been suggested to correlate with prognosis in a variety of diseases in previous studies; however, studies of these two markers in ulcerative colitis (UC) are lacking. The aim of this study was to evaluate the clinical significance of AFR and CALLY index in UC.

Methods

The study included 109 UC patients and 126 healthy controls. For UC patients treated with Vedolizumab (50 patients), they were categorized into mucosal healing group (MH group) and non- mucosal healing group (non-MH group) based on Mayo endoscopic score (MES) after 14 weeks of treatment. The differences in AFR and CALLY index were compared between the UC group and the healthy control group, and between the MH group and the non-MH group. Then, the correlation of the AFR and CALLY index with UC activity was assessed, and the predictive value of the AFR and CALLY index was evaluated using the receiver operating characteristic (ROC) curve.

Results

The results showed that both AFR and CALLY index were significantly decreased in the UC group compared with the healthy control group (both p<0.001); the area under the curve (AUC) of the AFR and CALLY index differentiating between the healthy control group and the UC group were 0.782 and 0.773, respectively. For Vedolizumab treatment, the non-MH group had significantly lower baseline AFR and CALLY index compared to the MH group; the AUC for baseline AFR and CALLY index discriminating the MH group from the non-MH group were 0.665 and 0.721, respectively. In addition, AFR and CALLY index were negatively correlated with the MES and inflammatory load of UC. The results of multivariate logistic regression analysis showed that the CALLY index was an independent predictor of UC diagnosis and mucosal healing after 14 weeks of Vedolizumab treatment.

Conclusion

AFR and CALLY index can be used as novel serologic markers for diagnosing UC and predicting the efficacy of Vedolizumab treatment.