Role of the Charlson Comorbidity Index in Predicting Long-Term Outcomes in Cardiovascular Disease Patients: A Narrative Review

Cardiovascular disease (CVD) remains the leading cause of global morbidity and mortality, with comorbidities significantly influencing patient outcomes. Accurate risk stratification tools are essential for optimizing clinical management and predicting long-term prognosis. The Charlson Comorbidity Index (CCI), developed initially to predict 1-year mortality in hospitalized patients, has emerged as a valuable instrument for evaluating comorbidity burden in various medical specialties, including cardiology. This narrative review explores the role of the CCI in predicting long-term outcomes in patients with CVD, examining its applicability, strengths, and limitations across different CVD subtypes. A narrative review of literature from PubMed, Scopus, and Google Scholar was conducted, focusing on studies published between 2000 and 2025 that evaluated the predictive value of the CCI in cardiovascular populations. Studies were included that assessed mortality, hospital readmissions, and other long-term clinical outcomes. Numerous studies demonstrate that higher CCI scores are strongly associated with increased long-term mortality, hospital readmissions, and adverse cardiovascular events in patients with conditions such as coronary artery disease, heart failure, and atrial fibrillation. The CCI provides significant prognostic value independent of traditional cardiovascular risk factors. However, limitations exist, including its inability to account for dynamic changes in health status and lack of specificity for cardiovascular pathology. The CCI remains a valuable tool for predicting long-term outcomes in CVD patients. Integrating disease-specific models and real-time clinical data may enhance precision and clinical utility in modern cardiovascular practice.