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The CALLY Index as an integrated inflammation-nutrition biomarker for risk stratification in HFpEF.

Created on 21 Jul 2026

Authors

Jing Ge, Jinqi Liu, Yali Zhang, Dongdong Zhang, Shen Wu, Changjiang Xu, Dongying Zhang

Published in

BMC cardiovascular disorders. Jul 20, 2026. Epub Jul 20, 2026.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a complex systemic syndrome characterized by inflammation, metabolic dysregulation, and immune imbalance. However, simple and integrative biomarkers for risk stratification remain limited. The C-reactive protein-albumin-lymphocyte (CALLY) index, reflecting inflammation, nutritional status, and immune function, has shown prognostic value in various diseases, but its role in HFpEF remains unclear.
In this single-center retrospective cohort study, 308 patients with HFpEF were enrolled. The CALLY index was calculated as albumin × lymphocyte count / CRP. The primary endpoint was major adverse cardiovascular events (MACE), defined as all-cause death or heart failure rehospitalization. Cox proportional hazards models, restricted cubic spline (RCS), receiver operating characteristic (ROC) analysis, and Kaplan-Meier curves were applied.
During follow-up, 87 patients (28.25%) experienced MACE. Multivariable Cox analysis identified the CALLY index (HR = 0.98, 95% CI: 0.96-0.99) and E/e' (HR = 1.08, 95% CI: 1.01-1.17) as independent predictors of MACE. RCS analysis demonstrated a nonlinear inverse association between the CALLY index and MACE risk. ROC analysis showed good predictive performance (AUC = 0.82). Patients with lower CALLY index (< 11.8) had significantly higher event rates (log-rank p < 0.001).
The CALLY index is an independent predictor of long-term outcomes in HFpEF, integrating inflammation, nutrition, and immune status. It may serve as a simple and practical tool for risk stratification.

PMID:
42477577
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.

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