Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index

Muhammed Raşit Tanırcan; Adem Aktan; Raif Kılıç; Tuncay Güzel; Mehmet Kış; Ali Evsen; Mehmet Sait Coşkun; Mehmet Zülkif Karahan

doi:10.18614/dehm.1979168

Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index

Abstract

Background: In patients with chronic total occlusion, collateral development varies despite similar angiographic disease burden. The C-reactive protein–albumin–lymphocyte (CALLY) index may reflect systemic inflammatory, nutritional, and immune status, but its association with collateral development in chronic total occlusion (CTO) is not well defined. Methods: We retrospectively evaluated 306 consecutive patients diagnosed with CTO on coronary angiography at a single center between January 2023 and December 2025. Angiographic collateralization was stratified via the Rentrop criteria, where categories 0–1 represented suboptimal vascular recruitment, whereas classes 2–3 denoted a well-developed collateral network. Baseline clinical features, laboratory measurements, and angiographic findings were analyzed according to collateral status. Logistic regression models were used to test the independent relationship between the CALLY index and good collateral development, while ROC analysis assessed its discriminatory performance. Results: Patients with poor collateral development showed a more pronounced inflammatory profile, accompanied by lower albumin levels, lymphocyte counts, and CALLY index values. The median CALLY index was lower among patients with poor collateralization than among those with good collateralization [2.70 (1.30–7.33) vs. 4.56 (2.42–9.27), p<0.001]. After adjustment for potential confounders, higher CALLY index values were independently associated with good collateral development (OR: 1.03, 95% CI: 1.01–1.05, p=0.005). ROC curve analysis showed that the CALLY index had limited but statistically significant discriminatory ability for identifying good collateral development (AUC: 0.621, p<0.001). Conclusion: Higher CALLY index values were independently associated with better coronary collateral development in patients with CTO. Conversely, lower CALLY index values may reflect an unfavorable inflammatory and nutritional profile related to impaired collateralization.

Keywords

Supporting Institution

No financial or institutional support was received for this study.

Project Number

Not applicable.

Ethical Statement

The study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the local ethics committee (XXX Ethics Committee; Protocol No: 2026/04-14; approval date: 24.04.2026). Because of the retrospective design, the requirement for written informed consent was waived.

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Details

Primary Language

English

Subjects

Internal Diseases

Journal Section

Research Article

Authors

Muhammed Raşit Tanırcan ^*
0000-0002-7480-9983
Türkiye

Adem Aktan
0000-0003-0505-9784
Türkiye

Raif Kılıç
0000-0002-8338-4948
Türkiye

Tuncay Güzel
0000-0001-8470-1928
Türkiye

Mehmet Kış
0000-0003-0775-8992
Türkiye

Ali Evsen
0000-0002-3780-7137
Türkiye

Mehmet Sait Coşkun
0000-0001-8285-7574
Türkiye

Mehmet Zülkif Karahan
0000-0001-8145-9574
Türkiye

Publication Date

October 26, 2026

Submission Date

June 25, 2026

Acceptance Date

August 4, 2026

Published in Issue

Year 2026 Volume: 40 Number: 4

DOI

https://doi.org/10.18614/dehm.1979168

IZ

https://izlik.org/JA85RW42HW

Cite

RIS / Bibtex

APA

Tanırcan, M. R., Aktan, A., Kılıç, R., Güzel, T., Kış, M., Evsen, A., Coşkun, M. S., & Karahan, M. Z. (2026). Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index. Developments and Experiments in Health and Medicine, 40(4), 481-489. https://doi.org/10.18614/dehm.1979168

AMA

1.Tanırcan MR, Aktan A, Kılıç R, et al. Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index. Dev Exp Health Med. 2026;40(4):481-489. doi:10.18614/dehm.1979168

Chicago

Tanırcan, Muhammed Raşit, Adem Aktan, Raif Kılıç, et al. 2026. “Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index”. Developments and Experiments in Health and Medicine 40 (4): 481-89. https://doi.org/10.18614/dehm.1979168.

EndNote

Tanırcan MR, Aktan A, Kılıç R, Güzel T, Kış M, Evsen A, Coşkun MS, Karahan MZ (October 1, 2026) Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index. Developments and Experiments in Health and Medicine 40 4 481–489.

IEEE

[1]M. R. Tanırcan et al., “Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index”, Dev Exp Health Med, vol. 40, no. 4, pp. 481–489, Oct. 2026, doi: 10.18614/dehm.1979168.

ISNAD

Tanırcan, Muhammed Raşit - Aktan, Adem - Kılıç, Raif - Güzel, Tuncay - Kış, Mehmet - Evsen, Ali - Coşkun, Mehmet Sait - Karahan, Mehmet Zülkif. “Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index”. Developments and Experiments in Health and Medicine 40/4 (October 1, 2026): 481-489. https://doi.org/10.18614/dehm.1979168.

JAMA

1.Tanırcan MR, Aktan A, Kılıç R, Güzel T, Kış M, Evsen A, Coşkun MS, Karahan MZ. Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index. Dev Exp Health Med. 2026;40:481–489.

MLA

Tanırcan, Muhammed Raşit, et al. “Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index”. Developments and Experiments in Health and Medicine, vol. 40, no. 4, Oct. 2026, pp. 481-9, doi:10.18614/dehm.1979168.

Vancouver

1.Muhammed Raşit Tanırcan, Adem Aktan, Raif Kılıç, Tuncay Güzel, Mehmet Kış, Ali Evsen, Mehmet Sait Coşkun, Mehmet Zülkif Karahan. Systemic Inflammatory–Nutritional Status and Coronary Collateral Development in Chronic Total Occlusion: The Role of the CALLY Index. Dev Exp Health Med. 2026 Oct. 1;40(4):481-9. doi:10.18614/dehm.1979168