A high baseline CALLY index was associated with a significantly lower risk of 30-day acute kidney injury after TAVR compared to a low CALLY index (HR 0.50; 95% CI 0.29-0.85; p=0.011).
Cohort (n=816)
Does the baseline CALLY index predict 30-day all-cause mortality, acute kidney injury, and stroke in patients undergoing TAVR?
Higher baseline CALLY index values are associated with a significantly lower risk of 30-day acute kidney injury following TAVR, suggesting its utility as a simple inflammatory-nutritional prognostic marker.
Hazard Ratio: 0.5 (95% CI 0.29–0.85)
p-value: p=0.011
BACKGROUND: Systemic inflammation and nutritional status influence outcomes after transcatheter aortic valve replacement (TAVR). The C-reactive protein-albumin-lymphocyte (CALLY) index integrates these domains, but its short-term prognostic value and potential nonlinear associations after TAVR remain uncertain. AIMS: To evaluate the association of baseline CALLY with 30-day all-cause mortality, acute kidney injury (AKI), and stroke after TAVR, and to explore potential nonlinear relationships. METHODS: We retrospectively analyzed 816 consecutive TAVR patients stratified into low (n = 272), middle (n = 273), and high (n = 271) CALLY tertiles. Outcomes were defined according to Valve Academic Research Consortium-3 criteria. Cox models estimated crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable models were adjusted for age, sex, diabetes, and baseline creatinine. Exploratory piecewise Cox models assessed nonlinearity. RESULTS: Within 30 days, 28 patients died (3.4%), 81 developed AKI (9.9%), and 35 experienced stroke (4.3%). Compared with the low tertile, the middle and high tertiles were associated with lower adjusted risks of AKI (middle: HR 0.53, 95% CI 0.31-0.90; p = 0.018; high: HR 0.50, 95% CI 0.29-0.85; p = 0.011). A similar inverse trend was observed for mortality (high vs. low: HR 0.43, 95% CI 0.18-1.06; p = 0.066), although statistical significance was not reached. No significant association was observed for stroke. Piecewise modeling demonstrated a significant overall association between CALLY and AKI (p = 0.043), suggesting a nonlinear threshold-type relationship with higher risk concentrated at lower CALLY values. CONCLUSIONS: Higher CALLY values were associated with a lower risk of 30-day AKI after TAVR, with evidence of a nonlinear threshold-type relationship. CALLY may serve as a simple inflammatory-nutritional marker for identifying patients at increased risk of early renal complications.
Khadija et al. (Sun,) conducted a cohort in Transcatheter aortic valve replacement (TAVR) (n=816). High CALLY index (high tertile) vs. Low CALLY index (low tertile) was evaluated on 30-day acute kidney injury (AKI) (HR 0.50, 95% CI 0.29-0.85, p=0.011). A high baseline CALLY index was associated with a significantly lower risk of 30-day acute kidney injury after TAVR compared to a low CALLY index (HR 0.50; 95% CI 0.29-0.85; p=0.011).