Evaluation of the Association Between the CALLY Index, Functional Class, and Mortality in Patients with Heart Failure with Reduced Ejection Fraction Düşük Ejeksiyon Fraksiyonlu Kalp Yetersizliği Hastalarında CALLY İndeksi ile Fonksiyonel Sınıf ve Mortalite Arasındaki İlişkinin Değerlendirilmesi
Medical Journal of Bakirkoy, cilt.21, sa.4, ss.436-443, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/bmj.galenos.2025.2025.9-7
- Dergi Adı: Medical Journal of Bakirkoy
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.436-443
- Anahtar Kelimeler: HFrEF, CALLY index, mortality, NYHA
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Heart failure with reduced ejection fraction (HFrEF) remains a major global health challenge. The New York Heart Association (NYHA) functional classification remains an indispensable instrument for evaluating symptom severity and carries recognized prognostic value in this patient population. Nevertheless, there is a growing need for accessible, objective markers that can help predict outcomes more accurately. The C-reactive protein-albumin-lymphocyte (CALLY) index, derived from C-reactive protein (CRP), albumin, and lymphocyte count, offers a composite measure that reflects systemic inflammation, nutritional status, and immune function. This study aimed to evaluate the association between the CALLY index, NYHA class, and all-cause of mortality in patients with HFrEF. Methods: Patients diagnosed with HFrEF from January 2023 to April 2025 were retrospectively evaluated. Patients were categorized as survivors or non-survivors. Clinical characteristics, laboratory findings, and NYHA functional class were systematically compared between the two groups. To explore factors independently associated with mortality, both univariate and multivariate logistic regression analyses were conducted. Additionally, the prognostic performance of the CALLY index was assessed using receiver operating characteristic (ROC) curve analysis. Results: Among 146 patients diagnosed with HFrEF, 29 (19.8%) experienced all-cause of mortality. Compared with survivors, those who died were older, had significantly lower left ventricular ejection fraction (LVEF), and showed higher levels of inflammatory and cardiac biomarkers, including CRP, troponin-T, and pro-brain natriuretic peptide. Advanced heart failure symptoms (NYHA class 3-4) were more common among non-survivors. Notably, the CALLY index—reflecting a combination of inflammation, nutritional status, and immune function—was markedly lower in the mortality group. In both univariate and multivariate logistic regression analyses, LVEF, NYHA class 3-4, and the CALLY index were independently associated with mortality. ROC curve analysis showed that the CALLY index had good predictive value for all-cause of mortality and moderate predictive value for NYHA class 3-4, supporting its potential as a practical tool in clinical risk assessment. Conclusion: The CALLY index, which integrates markers of inflammation, nutrition, and immune status, was independently associated with all-cause of mortality and correlated with symptom severity in patients with HFrEF.