Objectives: Systemic inflammation, malnutrition, and immune dysregulation have emerged as important determinants of long-term outcomes after transcatheter aortic valve implantation (TAVI). The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel immunonutritional biomarker that integrates these pathophysiological domains; however, its prognostic value in TAVI patients has not yet been investigated. This study aimed to evaluate the association between the CALLY index and 1-year mortality after TAVI. Methods: This retrospective observational study included 532 consecutive patients who underwent TAVI at a tertiary-care center between 2014 and 2023. Baseline laboratory parameters were obtained before the procedure, and the CALLY index was calculated as (albumin × lymphocyte count)/(C-reactive protein × 10). The primary endpoint was 1-year mortality. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminative ability of the CALLY index and conventional surgical risk scores. Multivariable regression analyses were used to identify independent predictors of mortality. Results: During the 1-year follow-up period, 85 patients (15.9%) died. Patients who died had significantly lower baseline CALLY index values compared to survivors (p < 0.001). The CALLY index demonstrated good discriminative performance for 1-year mortality (AUC: 0.797), outperforming EuroSCORE II (AUC: 0.705) and the Society of Thoracic Surgeons (STS) score (AUC: 0.619). A CALLY cut-off value of 0.45, derived using Youden’s index, was associated with a more than threefold increased risk of mortality. In multivariable analysis, the CALLY index remained independently associated with 1-year mortality, along with EuroSCORE II and more than mild mitral regurgitation. Conclusions: The CALLY index is a strong and independent predictor of 1-year mortality after TAVI and provides incremental prognostic value beyond conventional surgical risk scores. Given its simplicity and reliance on routinely available laboratory parameters, the CALLY index may serve as a practical tool for long-term risk stratification in patients undergoing TAVI.

Conventional risk scores such as the Society of Thoracic Surgeons (STS) score are widely used for risk assessment in patients undergoing transcatheter aortic valve implantation (TAVI), yet they may not fully capture systemic inflammatory and nutritional burden. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is an integrated biomarker reflecting inflammation and nutritional reserve. To investigate the association between HALP and 2-year mortality after TAVI and to evaluate whether HALP provides incremental prognostic information beyond STS. This two-center retrospective cohort included 544 consecutive TAVI patients. The primary endpoint was all-cause death within 2 years after TAVI (binary outcome: yes/no). Independent predictors were assessed using multivariable logistic regression (HALP scaled per 10-unit increase). Discrimination was evaluated by receiver operating characteristic (ROC) analyses for HALP, STS, and a combined STS+HALP model. Within 2 years, 154 patients (28.3%) died. Patients who died had higher STS scores and lower HALP scores. HALP showed weak negative correlations with STS and EuroSCORE II (r ≈ - 0.11). In multivariable analysis, HALP remained independently associated with mortality (per 10-unit increase: OR 0.859, 95% CI 0.770-0.960; p = 0.007), while STS score was also independent (OR 1.112, 95% CI 1.045-1.184; p = 0.001). Discrimination was modest for HALP (AUC 0.591) and STS (AUC 0.622), and higher for the combined model (AUC 0.663). HALP is independently associated with 2-year all-cause mortality after TAVI and yielded a higher AUC when incorporated into the STS model, suggesting incremental prognostic information beyond conventional risk assessment.