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Research Article: Is the Cally index truly a prognostic marker that predicts mortality in older patients with acute coronary syndrome?

Date Published: 2026-07-23

Abstract:
The C-reactive protein (CRP) -albumin- lymphocyte (CALLY) index has recently emerged as a promising prognostic marker, which reflecting inflammatory, nutrional and immunological statuses. However, no study has reported the prognostic value of the CALLY index in older patients with acute coronary syndrome (ACS). The aim of the study is to determine whether the CALLY index can serve as a reliable predictor of all- cause mortality in older patients with ACS. This study was conducted retrospectively in patients aged ? 75 years old with ACS. The study comprised 440 patients diagnosed with ACS at our hospital May 2015 to August 2024. The median follow-up time was 23 months. The CALLY index was computed using the formula: (serum albumin (g/dL)×lymphocyte (10 9 /L)/CRP (mg/L)×10). The primary outcome was all-cause mortality from the day of admission. A total of 475 ACS patients over 75 years old were ultimately enrolled in this study. 35 patients were excluded due to missing follow-up data and active infection. The patients were divided into two groups according to the CALLY index: low CALLY (? 0.083, n:219), high CALLY (> 0.083, n:221). The low CALLY index appears to be a valuable tool for predicting mortality in older patients with ACS. Kaplan–Meier analysis demonstrated that a low CALLY index was significantly associated with low survival rate. Our study revealed that the CALLY index provides statistically significant independent predictor in older patients' prognosis in all-cause mortality. All- cause mortality was 48.2% (n:212) in both groups. In the low CALLY index group, a higher rate of all- cause mortality was observed [group 1, n:130 (59.4%)]. Based on the findings of our study, the CALLY index appears to be a practical and easily applicable tool for assessing mortality risk in elderly patients with acute coronary syndrome.

Introduction:
The C-reactive protein (CRP) -albumin- lymphocyte (CALLY) index has recently emerged as a promising prognostic marker, which reflecting inflammatory, nutrional and immunological statuses. However, no study has reported the prognostic value of the CALLY index in older patients with acute coronary syndrome (ACS). The aim of the study is to determine whether the CALLY index can serve as a reliable predictor of all- cause mortality in older patients with ACS.

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