Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction

Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical condition characterized by the interplay of malnutrition and immune inflammation, especially in elderly patients. The CRP-Albumin-Lymphocyte (CALLY) index, a novel composite indicator reflectin...

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Main Authors: Qingwei He, Yukun Cao, Xingman Fan, Bowen Li, Qiongyi He, Haitao Zhang
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Experimental Gerontology
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Online Access:http://www.sciencedirect.com/science/article/pii/S0531556525000737
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author Qingwei He
Yukun Cao
Xingman Fan
Bowen Li
Qiongyi He
Haitao Zhang
author_facet Qingwei He
Yukun Cao
Xingman Fan
Bowen Li
Qiongyi He
Haitao Zhang
author_sort Qingwei He
collection DOAJ
description Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical condition characterized by the interplay of malnutrition and immune inflammation, especially in elderly patients. The CRP-Albumin-Lymphocyte (CALLY) index, a novel composite indicator reflecting immune inflammation and nutritional status, has not yet been validated as a prognostic tool in elderly patients with HFpEF. Methods: This retrospective study included 320 elderly patients hospitalized at the Air Force Medical Center from October 2016 to April 2019 due to HFpEF. Patients were stratified into the all-cause mortality and the survival groups according to follow-up outcomes. Kaplan–Meier analysis and Cox regression were performed to identify risk factors associated with poor prognosis. Additionally, we constructed and evaluated a nomogram based on the CALLY index to predict survival rates. Results: During the follow-up period, 137 cases (42.81 %) of patients experienced all-cause mortality. Kaplan-Meier survival curves and Cox regression analysis revealed that a lower CALLY index (HR 0.811, 95 % CI 0.714–0.921, P = 0.001) was independently associated with adverse prognosis in elderly patients with HFpEF. The nomogram incorporating the CALLY index exhibited robust predictive performance for predicting 1-year, 3-year, and 5-year survival outcomes. Conclusion: Our findings demonstrate that the CALLY index is an independent predictor of long-term mortality in elderly patients with HFpEF. The developed nomogram incorporating the CALLY index could effectively predict survival probabilities.
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spelling doaj-art-d64b45518d504fd3960b3b15d59df0c02025-08-20T03:18:58ZengElsevierExperimental Gerontology1873-68152025-06-0120411274410.1016/j.exger.2025.112744Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fractionQingwei He0Yukun Cao1Xingman Fan2Bowen Li3Qiongyi He4Haitao Zhang5The Fifth School of Clinical Medicine, Air Force Clinical Medical School, Anhui Medical University, 230032 Hefei, Anhui, China; Department of Cardiology, Air Force Medical Center, Air Force Medical University, PLA, 100142 Beijing, ChinaDepartment of Cardiology, Air Force Medical Center, Air Force Medical University, PLA, 100142 Beijing, ChinaDepartment of Cardiology, Air Force Medical Center, Air Force Medical University, PLA, 100142 Beijing, China; Graduate School, Hebei North University, 075000 Zhangjiakou, Hebei, ChinaGraduate School, Hebei North University, 075000 Zhangjiakou, Hebei, ChinaThe Fifth School of Clinical Medicine, Air Force Clinical Medical School, Anhui Medical University, 230032 Hefei, Anhui, ChinaDepartment of Cardiology, Air Force Medical Center, Air Force Medical University, PLA, 100142 Beijing, China; Corresponding author.Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical condition characterized by the interplay of malnutrition and immune inflammation, especially in elderly patients. The CRP-Albumin-Lymphocyte (CALLY) index, a novel composite indicator reflecting immune inflammation and nutritional status, has not yet been validated as a prognostic tool in elderly patients with HFpEF. Methods: This retrospective study included 320 elderly patients hospitalized at the Air Force Medical Center from October 2016 to April 2019 due to HFpEF. Patients were stratified into the all-cause mortality and the survival groups according to follow-up outcomes. Kaplan–Meier analysis and Cox regression were performed to identify risk factors associated with poor prognosis. Additionally, we constructed and evaluated a nomogram based on the CALLY index to predict survival rates. Results: During the follow-up period, 137 cases (42.81 %) of patients experienced all-cause mortality. Kaplan-Meier survival curves and Cox regression analysis revealed that a lower CALLY index (HR 0.811, 95 % CI 0.714–0.921, P = 0.001) was independently associated with adverse prognosis in elderly patients with HFpEF. The nomogram incorporating the CALLY index exhibited robust predictive performance for predicting 1-year, 3-year, and 5-year survival outcomes. Conclusion: Our findings demonstrate that the CALLY index is an independent predictor of long-term mortality in elderly patients with HFpEF. The developed nomogram incorporating the CALLY index could effectively predict survival probabilities.http://www.sciencedirect.com/science/article/pii/S0531556525000737CRP–albumin–lymphocyte (CALLY)Heart failure with preserved ejection fraction (HFpEF)NutritionPrognosisAll-cause mortality
spellingShingle Qingwei He
Yukun Cao
Xingman Fan
Bowen Li
Qiongyi He
Haitao Zhang
Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
Experimental Gerontology
CRP–albumin–lymphocyte (CALLY)
Heart failure with preserved ejection fraction (HFpEF)
Nutrition
Prognosis
All-cause mortality
title Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
title_full Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
title_fullStr Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
title_full_unstemmed Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
title_short Long-term prognostic value of CRP–albumin–lymphocyte index in elderly patients with heart failure with preserved ejection fraction
title_sort long term prognostic value of crp albumin lymphocyte index in elderly patients with heart failure with preserved ejection fraction
topic CRP–albumin–lymphocyte (CALLY)
Heart failure with preserved ejection fraction (HFpEF)
Nutrition
Prognosis
All-cause mortality
url http://www.sciencedirect.com/science/article/pii/S0531556525000737
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