Clinical Prognostic Impact of CALLY in Heart Failure Patients With Different Ejection Fractions: A Retrospective Study.

BACKGROUND

Chronic heart failure (CHF) is closely linked to high morbidity and mortality rates, with inflammation and changes in nutritional status being key contributors to disease progression. Thus, this study aimed to evaluate the prognostic utility of the novel composite index CALLY, which incorporates albumin (ALB) level, lymphocyte count (LYM), and C-reactive protein (CRP) level, for predicting all-cause mortality in patients with CHF and varying ejection fractions.

METHODS

This retrospective cohort study included 1193 patients with CHF who were admitted to the First Affiliated Hospital of Kunming Medical University between January 2017 and October 2021. Restricted cubic spline analysis was used to determine the CALLY index cutoff value and classify patients into two groups. Kaplan-Meier and multivariable Cox regression analyses were performed to assess the prognostic value of CALLY in the overall cohort and in subgroups with HFrEF, HFmrEF, and HFpEF. Model performance was evaluated using receiver operating characteristic curves with DeLong's test, calibration curves with bootstrap resampling, and decision curve analysis.

RESULTS

Kaplan‒Meier analysis revealed that lower CALLY levels were associated with higher all-cause mortality in all patients with CHF and in the twoCHF subgroups. Multivariable Cox proportional hazards analysis demonstrated that CALLY independently predicted all-cause mortality across all heart failure subtypes. Receiver operating characteristic curve analysis indicated that models incorporating CALLY exhibited improved predictive performance. Calibration and decision curve analyses further supported the clinical utility of the CALLY index.

CONCLUSIONS

Amongpatients with CHF in this cohort, a lower CALLY index was independently associated with higher all-cause mortality across different ejection fraction categories. These findings suggest that CALLY may serve as a potential risk marker.