Evaluating the predictive value of the CALLY index for MACE events in STEMI patients: a comparative analysis across admission and discharge time points

评估CALLY指数对STEMI患者主要不良心血管事件的预测价值:入院和出院时间点的比较分析

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Abstract

BACKGROUND: Significant mortality and morbidity are caused by ST-segment elevation myocardial infarction (STEMI), emphasising the necessity for reliable predictive instruments. The aim of this study is to assess the predictive value of the CALLY index at different points in time for the long-term prognosis of patients with STEMI who have undergone percutaneous coronary intervention (PCI). METHODS: This retrospective study included 421 patients diagnosed with STEMI. The C-reactive protein-albumin-lymphocyte(CALLY) Index was collected at admission, 12-48 h after PCI, and at discharge. Univariate and multivariate Cox proportional hazard models were employed to identify independent factors influencing the prognosis of STEMI. The receiver operating characteristic (ROC) curves were utilized to determine the optimal predictive value of the CALLY index. Additionally, Kaplan-Meier analysis was conducted to assess the relationship between the CALLY index and major adverse cardiovascular events (MACEs). RESULTS: The primary outcome indicated that high levels of the CALLY index at 24 h post-PCI (threshold = 0.77) were significant independent prognostic factors for long-term MACEs among STEMI patients (hazard ratio,0.303; 95% confidence interval, 0.207-0.445; P < 0.001). Among the evaluated variables, the CALLY index at 24 h post-PCI exhibited the highest accuracy in predicting MACEs in STEMI patients during long-term follow-up (AUC: 0.712, P < 0.001). Furthermore, the CALLY index at 24 h post-PCI was significantly associated with no-reflow phenomenon (P = 0.006) and Gensini score (P < 0.001), demonstrating its relationship with coronary disease severity and reperfusion quality.

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