A lower admission C-reactive protein-albumin-lymphocyte index was independently associated with clinically documented 30-day new-onset atrial fibrillation after percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and may provide incremental predictive information.
New-onset atrial fibrillation occurred in 8.4% of STEMI patients undergoing primary PCI within 30 days.
The CALLY index was independently and inversely associated with new-onset atrial fibrillation in multivariable logistic regression.
Four additional variables were independently associated with new-onset atrial fibrillation: left atrial diameter, infarct-related artery involvement of the right coronary artery, left ventricular ejection fraction, and fasting blood glucose.
Among individual biomarkers examined, the CALLY index demonstrated the highest predictive ability for new-onset atrial fibrillation.
Adding the CALLY index to a baseline clinical model significantly improved risk reclassification for new-onset atrial fibrillation.
The study design was a single-center retrospective cohort, and the authors note external validation is required before clinical application.
This research suggests that a blood test composite score called the CALLY index — which combines C-reactive protein (a marker of inflammation), albumin (a marker of nutrition), and lymphocyte count (a marker of immune function) — measured at hospital admission can help predict which heart attack patients are likely to develop a heart rhythm problem called atrial fibrillation (AF) within 30 days of having a procedure to open blocked arteries. In a group of 665 patients who had this procedure (primary PCI) for a serious type of heart attack (STEMI), about 8.4% developed new-onset AF. Patients with lower CALLY index scores were more likely to develop AF, suggesting that worse inflammation, poorer nutritional status, and impaired immune function at the time of admission are linked to higher AF risk. The CALLY index outperformed its individual component biomarkers in predicting AF, achieving an area under the curve of 0.743. When added to a model that already included established risk factors such as left atrial size, heart function, blood sugar, and which coronary artery was blocked, the CALLY index meaningfully improved the ability to correctly classify patients' risk. Other independent predictors of new-onset AF included a larger left atrial diameter, right coronary artery involvement, lower heart pumping function, and higher fasting blood glucose. This research suggests that a single composite blood score taken on admission could add useful information for identifying STEMI patients at elevated risk of developing atrial fibrillation after their procedure. However, because this was a single-center retrospective study, the authors caution that the findings need to be confirmed in other patient populations before the CALLY index could be routinely used in clinical practice.
Jin M, Peng S, Liu K, Yin J, Li F, Zhang Y. (2026). The C-reactive protein-albumin-lymphocyte index as a predictor of new-onset atrial fibrillation after ST-segment elevation myocardial infarction: A retrospective cohort study.. The Journal of international medical research. https://doi.org/10.1177/03000605261487233