Deng Ye, Huang Jianya, Deng Li, Zhou Yuxuan, Pan Lu, Wang Jingyi, Chen Qianwen, Gu Qingqing, Zhang Yang, Wei Jun, Wang Ruxing, Sun Ling, Ji Yuan, Wang Qingjie
Department of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China.
Department of Nephrology, Fudan University Affiliated Shanghai Fifth People's Hospital, Shanghai, China.
Clin Cardiol. 2025 Jun;48(6):e70157. doi: 10.1002/clc.70157.
Atrial fibrillation (AF) recurrence after catheter ablation remains a clinical challenge despite guideline-recommended efficacy. Emerging evidence implicates inflammatory biomarkers in predicting arrhythmia recurrence. This study investigated the novel CALLY index, a composite inflammatory marker, as a prognostic indicator for postablation AF recurrence.
In this prospective cohort study, 556 consecutive AF patients undergoing catheter ablation (June 2018-June 2023) were stratified into recurrence and sinus rhythm (SR) maintenance groups. Cox regression and Kaplan-Meier analyses evaluated associations between the CALLY index and recurrence risk. Predictive accuracy was assessed via receiver operating characteristic (ROC) curves and area under the curve (AUC).
Over a median 12-month follow-up, 102 patients (18.3%) experienced recurrence. The SR group exhibited significantly higher CALLY indices than the recurrence group (3.24 ± 1.68 vs. 1.89 ± 0.57; p < 0.001). Univariate Cox regression identified the CALLY index as inversely associated with recurrence (HR: 0.439, 95% CI: 0.292-0.659; p < 0.001), with persistence after multivariable adjustment (HR: 0.887, 95% CI: 0.789-0.956; p = 0.031). Tertile-based stratification revealed a 29% lower recurrence risk in the high-CALLY group versus the low-CALLY group (HR: 0.71, 95% CI: 0.68-0.76; p = 0.017). ROC analysis demonstrated optimal discrimination at a CALLY threshold ≥ 1.433 (AUC: 0.7899; sensitivity: 76.4%; specificity: 74.8%; p < 0.001).
The CALLY index independently predicts AF recurrence postablation, offering potential utility in risk stratification. These findings support its integration into clinical decision-making to optimize post-procedural management.
尽管导管消融术后房颤（AF）复发仍是一项临床挑战，但指南推荐的疗效显著。新出现的证据表明炎症生物标志物与心律失常复发的预测有关。本研究调查了新型综合炎症标志物CALLY指数作为导管消融术后房颤复发的预后指标。
在这项前瞻性队列研究中，556例连续接受导管消融的房颤患者（2018年6月至2023年6月）被分为复发组和窦性心律（SR）维持组。Cox回归和Kaplan-Meier分析评估了CALLY指数与复发风险之间的关联。通过受试者工作特征（ROC）曲线和曲线下面积（AUC）评估预测准确性。
在中位12个月的随访期内，102例患者（18.3%）出现复发。SR组的CALLY指数显著高于复发组（3.24±1.68 vs. 1.89±0.57；p<0.001）。单因素Cox回归确定CALLY指数与复发呈负相关（HR：0.439，95%CI：0.292-0.659；p<0.001），多变量调整后仍持续存在（HR：0.887，95%CI：0.789-0.956；p=0.031）。基于三分位数的分层显示，高CALLY组的复发风险比低CALLY组低29%（HR：0.71，95%CI：0.68-0.76；p=0.017）。ROC分析显示，当CALLY阈值≥1.433时具有最佳区分度（AUC：0.7899；敏感性：76.4%；特异性：74.8%；p<0.001）。
CALLY指数可独立预测导管消融术后房颤复发，在风险分层中具有潜在应用价值。这些发现支持将其纳入临床决策，以优化术后管理。
