Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010

Abstract Background Evidence regarding the C-reactive protein‒albumin‒lymphocyte (CALLY) index and mortality risk in individuals with cardiovascular disease (CVD) is scarce. This study investigated the relationships of the CALLY index with all-cause and cardiovascular mortality risk in CVD patients...

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Main Authors: Dunzheng Han, Lanlan Wu, Haobin Zhou, Yuting Xue, Shangfei He, Zhuang Ma, Shuwen Su, Peixin Li, Shenrong Liu, Zheng Huang
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04596-w
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author Dunzheng Han
Lanlan Wu
Haobin Zhou
Yuting Xue
Shangfei He
Zhuang Ma
Shuwen Su
Peixin Li
Shenrong Liu
Zheng Huang
author_facet Dunzheng Han
Lanlan Wu
Haobin Zhou
Yuting Xue
Shangfei He
Zhuang Ma
Shuwen Su
Peixin Li
Shenrong Liu
Zheng Huang
author_sort Dunzheng Han
collection DOAJ
description Abstract Background Evidence regarding the C-reactive protein‒albumin‒lymphocyte (CALLY) index and mortality risk in individuals with cardiovascular disease (CVD) is scarce. This study investigated the relationships of the CALLY index with all-cause and cardiovascular mortality risk in CVD patients among American adults. Methods This study enrolled 2183 CVD individuals from five NHANES cycles (2001–2010), and mortality outcomes were determined by linking the data to National Death Index (NDI) records up to December 31, 2019. Weighted multivariate Cox regression models and subgroup analyses were performed to assess the associations of the CALLY index with all-cause and cardiovascular mortality. A restricted cubic spline (RCS) was used to visualize the association of the CALLY index with mortality risk. Results During a median follow-up of 122 months (interquartile range, 71–157 months), 1208 (weighted percentage, 49.62%) of the 2183 CVD individuals died, including 398 (weighted percentage, 24.85%) with cardiovascular deaths and 810 (weighted percentage, 75.15%) with noncardiovascular deaths. Cox regression revealed an inverse correlation between the CALLY index and the risk of all-cause and cardiovascular mortality after adjusting for covariates. Compared with individuals with a lower CALLY index, those with a higher CALLY index had a significantly lower risk of both all-cause (HR 0.58, 95% CI: 0.48, 0.71, p < 0.001) and cardiovascular mortality (HR 0.54, 95% CI: 0.38, 0.76, p < 0.001). The RCS regression analysis revealed a nonlinear association between the CALLY index and all-cause and cardiovascular mortality (p < 0.05 for nonlinearity) in CVD patients. The associations were consistent in the subgroup analyses regardless of age, sex, income, education level, race, smoking status, diabetes, and hypertension (all p values for interactions > 0.05). Conclusion An increased CALLY index is independently associated with decreased all-cause and cardiovascular mortality in CVD patients.
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issn 1471-2261
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spelling doaj-art-5ce8764eaef14f8ab65010573b1c399b2025-08-20T02:59:19ZengBMCBMC Cardiovascular Disorders1471-22612025-03-0125111110.1186/s12872-025-04596-wAssociations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010Dunzheng Han0Lanlan Wu1Haobin Zhou2Yuting Xue3Shangfei He4Zhuang Ma5Shuwen Su6Peixin Li7Shenrong Liu8Zheng Huang9Department of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Cardiology, The First Affiliated Hospital, Guangzhou Medical UniversityAbstract Background Evidence regarding the C-reactive protein‒albumin‒lymphocyte (CALLY) index and mortality risk in individuals with cardiovascular disease (CVD) is scarce. This study investigated the relationships of the CALLY index with all-cause and cardiovascular mortality risk in CVD patients among American adults. Methods This study enrolled 2183 CVD individuals from five NHANES cycles (2001–2010), and mortality outcomes were determined by linking the data to National Death Index (NDI) records up to December 31, 2019. Weighted multivariate Cox regression models and subgroup analyses were performed to assess the associations of the CALLY index with all-cause and cardiovascular mortality. A restricted cubic spline (RCS) was used to visualize the association of the CALLY index with mortality risk. Results During a median follow-up of 122 months (interquartile range, 71–157 months), 1208 (weighted percentage, 49.62%) of the 2183 CVD individuals died, including 398 (weighted percentage, 24.85%) with cardiovascular deaths and 810 (weighted percentage, 75.15%) with noncardiovascular deaths. Cox regression revealed an inverse correlation between the CALLY index and the risk of all-cause and cardiovascular mortality after adjusting for covariates. Compared with individuals with a lower CALLY index, those with a higher CALLY index had a significantly lower risk of both all-cause (HR 0.58, 95% CI: 0.48, 0.71, p < 0.001) and cardiovascular mortality (HR 0.54, 95% CI: 0.38, 0.76, p < 0.001). The RCS regression analysis revealed a nonlinear association between the CALLY index and all-cause and cardiovascular mortality (p < 0.05 for nonlinearity) in CVD patients. The associations were consistent in the subgroup analyses regardless of age, sex, income, education level, race, smoking status, diabetes, and hypertension (all p values for interactions > 0.05). Conclusion An increased CALLY index is independently associated with decreased all-cause and cardiovascular mortality in CVD patients.https://doi.org/10.1186/s12872-025-04596-wCardiovascular diseaseMortalityC-reactive protein-albumin-lymphocyte index
spellingShingle Dunzheng Han
Lanlan Wu
Haobin Zhou
Yuting Xue
Shangfei He
Zhuang Ma
Shuwen Su
Peixin Li
Shenrong Liu
Zheng Huang
Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
BMC Cardiovascular Disorders
Cardiovascular disease
Mortality
C-reactive protein-albumin-lymphocyte index
title Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
title_full Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
title_fullStr Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
title_full_unstemmed Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
title_short Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001–2010
title_sort associations of the c reactive protein albumin lymphocyte index with all cause and cardiovascular mortality among individuals with cardiovascular disease evidence from the nhanes 2001 2010
topic Cardiovascular disease
Mortality
C-reactive protein-albumin-lymphocyte index
url https://doi.org/10.1186/s12872-025-04596-w
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