Key result
CALLY index <0.716 predicts ~341% higher in-hospital mortality in elderly ACS patients.
Why the study?
Older adults face a high risk of in-hospital mortality following acute coronary syndrome, and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index was unknown in this population.
Does the C-Reactive Protein-Albumin-Lymphocyte (CALLY) index predict in-hospital mortality in elderly patients admitted for acute coronary syndrome?
Cohort (n=699)
Does the C-Reactive Protein-Albumin-Lymphocyte (CALLY) index predict in-hospital mortality in elderly patients admitted for acute coronary syndrome?
Odds Ratio: 4.41 (95% CI 2.27–8.54)
p-value: p=<0.001
The CALLY index is a strong, independent predictor of in-hospital mortality in elderly patients with acute coronary syndrome, demonstrating higher sensitivity and specificity than the GRACE score.
May aid risk stratification in elderly ACS; hypothesis-generating and requires prospective validation.
Older adults face a high risk of in-hospital mortality following acute coronary syndrome (ACS). The C-reactive protein-albumin-lymphocyte (CALLY) index reflects systemic inflammation, immunity, and nutritional status. We investigated its predictive value for in-hospital mortality in elderly ACS patients. A total of 699 older patients diagnosed with ACS were retrospectively analyzed. The cohort was divided into survivors (n = 562) and non-survivors (n = 137). Admission values of serum C-reactive protein, albumin, and lymphocyte counts were utilized to compute the CALLY index. The non-survivor cohort exhibited a remarkably lower CALLY index compared with those who survived (0.22 [0.08-0.78] vs 3.09 [0.73-10.3], P < .001). A CALLY index threshold of ≤0.716 identified in-hospital mortality with 75.4% sensitivity and 74.5% specificity (Area under the curve [AUC] = 0.816, 95% CI: 0.776-0.856, P < .001), showing higher sensitivity and specificity than the Global Registry of Acute Coronary Events (GRACE) score. Multivariable regression revealed that CALLY index <0.716 (odds ratio [OR] = 4.41, 95% CI: 2.27-8.54, P < .001) independently predicted adverse outcomes. The CALLY index may serve as a valuable and independent prognostic marker in elderly patients with ACS.
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Kılıç et al. (2026) conducted a cohort in Acute Coronary Syndrome (n=699). CALLY index <0.716 vs. CALLY index ≥0.716 was evaluated on In-hospital mortality (OR 4.41, 95% CI 2.27-8.54, p=<0.001). A CALLY index <0.716 independently predicted in-hospital mortality among elderly patients with acute coronary syndrome (OR 4.41; 95% CI 2.27-8.54; P<0.001).
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