Association of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index With In-Hospital Mortality Among Elderly Patients Admitted for Acute Coronary Syndrome

Older adults face a high risk of in-hospital mortality following acute coronary syndrome (ACS). The C-reactive protein-albumin-lymphocyte (CALLY) index reflects systemic inflammation, immunity, and nutritional status. We investigated its predictive value for in-hospital mortality in elderly ACS patients. A total of 699 older patients diagnosed with ACS were retrospectively analyzed. The cohort was divided into survivors (n = 562) and non-survivors (n = 137). Admission values of serum C-reactive protein, albumin, and lymphocyte counts were utilized to compute the CALLY index. The non-survivor cohort exhibited a remarkably lower CALLY index compared with those who survived (0.22 [0.08-0.78] vs 3.09 [0.73-10.3], P  < .001). A CALLY index threshold of ≤0.716 identified in-hospital mortality with 75.4% sensitivity and 74.5% specificity (Area under the curve [AUC] = 0.816, 95% CI: 0.776-0.856, P  < .001), showing higher sensitivity and specificity than the Global Registry of Acute Coronary Events (GRACE) score. Multivariable regression revealed that CALLY index <0.716 (odds ratio [OR] = 4.41, 95% CI: 2.27-8.54, P  < .001) independently predicted adverse outcomes. The CALLY index may serve as a valuable and independent prognostic marker in elderly patients with ACS.