Prognostic value of CALLY index in combination with the GRACE score among patients with acute myocardial infarction: a retrospective cohort study

Objective The study aimed to investigate the prognostic value of the CRP-albumin-lymphocyte (CALLY) index for adverse outcomes in patients with AMI and evaluate the potential value of combining the CALLY index with the GRACE score to improve prognosis. Methods This study enrolled 1,127 patients with acute myocardial infarction (AMI) admitted to the Sinopharm Dongfeng General Hospital from 2021 to 2023. Patients were stratified into two cohorts based on the median CALLY index score. Kaplan–Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) analysis were used to assess the association between CALLY index levels and major adverse cardiovascular and cerebrovascular events (MACCE). Time-dependent receiver operating characteristic (Time-ROC) curves were constructed to evaluate the prognostic value of the CALLY index for AMI patients. Additionally, subgroup analyses were conducted to assess the robustness and consistency of this association across different clinical characteristics. Results During a median follow - up of 24 months, a total of 243 patients (24%) experienced a major adverse cardiovascular event (MACCE). The CALLY index in the MACCE group was significantly lower than that in the non - MACCE group. In the fully adjusted model, whether treated as a continuous variable (HR = 0.68; 95% CI: 0.51–0.90) or as a categorical variable (HR = 0.29; 95% CI: 0.19–0.44; P  P - value Conclusion The CALLY index was closely associated with patient prognosis in acute myocardial infarction (AMI) and significantly enhanced the predictive accuracy of the traditional GRACE score. The CALLY index was poised to emerge as a novel biomarker for prognostic stratification in AMI.