Prognostic value of CALLY index in combination with the GRACE score among patients with acute myocardial infarction: a retrospective cohort study.

Authors

Chuanglu Zhao, Rong Chen, Ruirui Feng, Xianlin Xu, Hang Sun, Xinwen Min, Handong Yang, Jishun Chen, Xiaolei Li

Published in

Frontiers in cardiovascular medicine. Volume 13. Pages 1858524. Epub Sep 18, 2026.

Abstract

The study aimed to investigate the prognostic value of the CRP-albumin-lymphocyte (CALLY) index for adverse outcomes in patients with AMI and evaluate the potential value of combining the CALLY index with the GRACE score to improve prognosis.
This study enrolled 1,127 patients with acute myocardial infarction (AMI) admitted to the Sinopharm Dongfeng General Hospital from 2021 to 2023. Patients were stratified into two cohorts based on the median CALLY index score. Kaplan-Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) analysis were used to assess the association between CALLY index levels and major adverse cardiovascular and cerebrovascular events (MACCE). Time-dependent receiver operating characteristic (Time-ROC) curves were constructed to evaluate the prognostic value of the CALLY index for AMI patients. Additionally, subgroup analyses were conducted to assess the robustness and consistency of this association across different clinical characteristics.
During a median follow - up of 24 months, a total of 243 patients (24%) experienced a major adverse cardiovascular event (MACCE). The CALLY index in the MACCE group was significantly lower than that in the non - MACCE group. In the fully adjusted model, whether treated as a continuous variable (HR = 0.68; 95% CI: 0.51-0.90) or as a categorical variable (HR = 0.29; 95% CI: 0.19-0.44; P < 0.001), a lower CALLY index was associated with an increased risk of MACCE in patients with AMI. RCS analysis revealed a nonlinear relationship between the CALLY index and prognosis in AMI patients (nonlinear P - value < 0.001). ROC curve analysis indicated that the CALLY index has good predictive ability for MACCE (AUC = 0.788; 95% CI: 0.742-0.835), and that combining the CALLY index with the GRACE score significantly improves predictive ability. In subgroup analyses, the CALLY index demonstrated good generalizability and robustness.
The CALLY index was closely associated with patient prognosis in acute myocardial infarction (AMI) and significantly enhanced the predictive accuracy of the traditional GRACE score. The CALLY index was poised to emerge as a novel biomarker for prognostic stratification in AMI.

PMID:
42827456
Bibliographic data and abstract were imported from PubMed on 03 Oct 2026.

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