Admission CALLY Index and Angiographic No-Reflow After Primary PCI in a Retrospective STEMI Cohort
4 affiliations
- 1Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya 54100, Turkey
- 2Department of Cardiology, Sakarya University School of Medicine, Sakarya 54100, Turkey
- 3Department of Cardiology, Tunceli State Hospital, Tunceli 62000, Turkey
- 4Department of Cardiology, Medipol University School of Medicine, İstanbul 34083, Turkey
Abstract
Background/Objectives: The CALLY index draws on three admission tests—C-reactive protein, albumin, and lymphocyte count. We investigated whether it was associated with angiographic no-reflow after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We reviewed 1245 patients treated at one center between January 2024 and January 2026. Logistic regression accounted for clinical risk factors, baseline Thrombolysis in Myocardial Infarction (TIMI) flow, culprit artery, thrombus grade 5, Killip class at the start of PCI, and door-to-balloon time. We also tested alternative endpoint definitions, assessed influential observations, and compared correlated receiver operating characteristic (ROC) curves. Results: No-reflow occurred in 206 patients (16.5%). CALLY was lower in this group than in the reflow group (median 1.11 [0.39–1.92] vs. 1.33 [0.73–2.11]). Each one-unit increase in ln(CALLY) was associated with lower odds of no-reflow after adjustment (odds ratio [OR] 0.800, 95% confidence interval [CI] 0.693–0.923; p = 0.0023). The association remained when the endpoint was limited to impaired final angiographic reperfusion (OR 0.832, 0.717–0.965; p = 0.015). Discrimination by CALLY alone was poor (area under the curve [AUC] 0.578, 0.534–0.623); it was not significantly better than its components or the other indices studied. At a displayed threshold of ≤0.905, positive and negative predictive values were 22.8% and 86.8%. The association weakened after removal of the upper and lower 1% of values (p = 0.063). Conclusions: Admission CALLY was associated with recorded angiographic no-reflow, even after broader adjustment. Its weak discrimination and small incremental contribution, however, do not support use for individual risk classification without further study.
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BibTeX
@article{turna2026admission,
title = {{Admission CALLY Index and Angiographic No-Reflow After Primary PCI in a Retrospective STEMI Cohort}},
author = {Fahrettin Turna and Emre Eynel and Muhammet Taşdemir and Arslan Nyyazov and Şevval Özdemir and Mehmet Şirin Yıldız and Emirhan Hancıoğlu and Yusuf Can and İbrahim Kocayiğit},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218724},
url = {https://www.mdpi.com/2077-0383/15/21/8724},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Admission CALLY Index and Angiographic No-Reflow After Primary PCI in a Retrospective STEMI Cohort
AU - Fahrettin Turna
AU - Emre Eynel
AU - Muhammet Taşdemir
AU - Arslan Nyyazov
AU - Şevval Özdemir
AU - Mehmet Şirin Yıldız
AU - Emirhan Hancıoğlu
AU - Yusuf Can
AU - İbrahim Kocayiğit
PY - 2026
DA - 2026/11/08
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218724
UR - https://www.mdpi.com/2077-0383/15/21/8724
AB - Background/Objectives: The CALLY index draws on three admission tests—C-reactive protein, albumin, and lymphocyte count. We investigated whether it was associated with angiographic no-reflow after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We reviewed 1245 patients treated at one center between January 2024 and January 2026. Logistic regression accounted for clinical risk factors, baseline Thrombolysis in Myocardial Infarction (TIMI) flow, culprit artery, thrombus grade 5, Killip class at the start of PCI, and door-to-balloon time. We also tested alternative endpoint definitions, assessed influential observations, and compared correlated receiver operating characteristic (ROC) curves. Results: No-reflow occurred in 206 patients (16.5%). CALLY was lower in this group than in the reflow group (median 1.11 [0.39–1.92] vs. 1.33 [0.73–2.11]). Each one-unit increase in ln(CALLY) was associated with lower odds of no-reflow after adjustment (odds ratio [OR] 0.800, 95% confidence interval [CI] 0.693–0.923; p = 0.0023). The association remained when the endpoint was limited to impaired final angiographic reperfusion (OR 0.832, 0.717–0.965; p = 0.015). Discrimination by CALLY alone was poor (area under the curve [AUC] 0.578, 0.534–0.623); it was not significantly better than its components or the other indices studied. At a displayed threshold of ≤0.905, positive and negative predictive values were 22.8% and 86.8%. The association weakened after removal of the upper and lower 1% of values (p = 0.063). Conclusions: Admission CALLY was associated with recorded angiographic no-reflow, even after broader adjustment. Its weak discrimination and small incremental contribution, however, do not support use for individual risk classification without further study.
SN - 2077-0383
ER -