Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
Association of the CALLY Index With 30-Day Outcomes After Transcatheter Aortic Valve Replacement.
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Abu Khadija Haitham, Abu Hamdeh Nizar, Masu'd Mohammad, Najajra Duha, Mahamid Ameer, Bagan Max, Kirzhner Alena, Khaled Majde Abu, Kogan Alexander, Sternik Leonid, Gandelman Gera, Sinnokrot Zeina, Besharieh Firas, Saed Rashed, Alshami Yasmeen, Baraghithi Nora I, Schiller Tal, Alnees Mohammad
Аннотация
BACKGROUND: Systemic inflammation and nutritional status influence outcomes after transcatheter aortic valve replacement (TAVR). The C-reactive protein-albumin-lymphocyte (CALLY) index integrates these domains, but its short-term prognostic value and potential nonlinear associations after TAVR remain uncertain.
AIMS: To evaluate the association of baseline CALLY with 30-day all-cause mortality, acute kidney injury (AKI), and stroke after TAVR, and to explore potential nonlinear relationships.
METHODS: We retrospectively analyzed 816 consecutive TAVR patients stratified into low (n = 272), middle (n = 273), and high (n = 271) CALLY tertiles. Outcomes were defined according to Valve Academic Research Consortium-3 criteria. Cox models estimated crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable models were adjusted for age, sex, diabetes, and baseline creatinine. Exploratory piecewise Cox models assessed nonlinearity.
RESULTS: Within 30 days, 28 patients died (3.4%), 81 developed AKI (9.9%), and 35 experienced stroke (4.3%). Compared with the low tertile, the middle and high tertiles were associated with lower adjusted risks of AKI (middle: HR 0.53, 95% CI 0.31-0.90; p = 0.018; high: HR 0.50, 95% CI 0.29-0.85; p = 0.011). A similar inverse trend was observed for mortality (high vs. low: HR 0.43, 95% CI 0.18-1.06; p = 0.066), although statistical significance was not reached. No significant association was observed for stroke. Piecewise modeling demonstrated a significant overall association between CALLY and AKI (p = 0.043), suggesting a nonlinear threshold-type relationship with higher risk concentrated at lower CALLY values.
CONCLUSIONS: Higher CALLY values were associated with a lower risk of 30-day AKI after TAVR, with evidence of a nonlinear threshold-type relationship. CALLY may serve as a simple inflammatory-nutritional marker for identifying patients at increased risk of early renal complications.
AIMS: To evaluate the association of baseline CALLY with 30-day all-cause mortality, acute kidney injury (AKI), and stroke after TAVR, and to explore potential nonlinear relationships.
METHODS: We retrospectively analyzed 816 consecutive TAVR patients stratified into low (n = 272), middle (n = 273), and high (n = 271) CALLY tertiles. Outcomes were defined according to Valve Academic Research Consortium-3 criteria. Cox models estimated crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable models were adjusted for age, sex, diabetes, and baseline creatinine. Exploratory piecewise Cox models assessed nonlinearity.
RESULTS: Within 30 days, 28 patients died (3.4%), 81 developed AKI (9.9%), and 35 experienced stroke (4.3%). Compared with the low tertile, the middle and high tertiles were associated with lower adjusted risks of AKI (middle: HR 0.53, 95% CI 0.31-0.90; p = 0.018; high: HR 0.50, 95% CI 0.29-0.85; p = 0.011). A similar inverse trend was observed for mortality (high vs. low: HR 0.43, 95% CI 0.18-1.06; p = 0.066), although statistical significance was not reached. No significant association was observed for stroke. Piecewise modeling demonstrated a significant overall association between CALLY and AKI (p = 0.043), suggesting a nonlinear threshold-type relationship with higher risk concentrated at lower CALLY values.
CONCLUSIONS: Higher CALLY values were associated with a lower risk of 30-day AKI after TAVR, with evidence of a nonlinear threshold-type relationship. CALLY may serve as a simple inflammatory-nutritional marker for identifying patients at increased risk of early renal complications.
Предметные рубрики MeSH
HumansFemaleMaleRetrospective StudiesRisk FactorsTime FactorsAged, 80 and overTreatment OutcomeBiomarkersStrokeRisk AssessmentAcute Kidney InjuryPredictive Value of TestsAgedC-Reactive ProteinNutritional StatusTranscatheter Aortic Valve ReplacementAortic Valve StenosisInflammation MediatorsSerum Albumin, HumanLymphocyte CountInflammation