ESC Heart Failure (Feb 2024)

Serum apolipoprotein B to apolipoprotein A‐I ratio predicts mortality in patients with heart failure

  • Shiyang Li,
  • Xiaoshuang Xie,
  • Xiaobin Zeng,
  • Shihai Wang,
  • Jianjun Lan

DOI
https://doi.org/10.1002/ehf2.14547
Journal volume & issue
Vol. 11, no. 1
pp. 99 – 111

Abstract

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Abstract Aims Apolipoproteins have been reported to be involved in many cardiovascular diseases. The aim of our study was to investigate the prognostic value of apolipoprotein B (ApoB) to apolipoprotein A‐I (ApoA‐I) ratio (ApoB/ApoA‐I) in patients with heart failure (HF). Methods and results We randomly assigned 2400 HF patients into the training cohort (n = 1400) and the validation cohort (n = 1000). Using a receiver operating characteristic curve, we identified the optimal cut‐off value of the ApoB/ApoA‐I in the training cohort as 0.69, which was further validated in the validation cohort. A propensity score matching (PSM) analysis was conducted to eliminate the imbalance in the baseline characteristics of the high and low ApoB/ApoA‐I group. A total of 2242 HF patients were generated in the PSM cohort. We also validated our results with an independent cohort (n = 838). Univariate and multivariate analyses were conducted to explore the independent prognostic value of ApoB/ApoA‐I in the training cohort (n = 1400), the validation cohort (n = 1000), the PSM cohort (n = 2242), and the independent cohort (n = 838). Patients with high ApoB/ApoA‐I ratio had significantly poorer prognosis compared with those with low ApoB/ApoA‐I ratio in the training cohort, the validation cohort, the PSM cohort, and the independent cohort (P < 0.05). Multivariate analysis indicated that the ApoB/ApoA‐I was an independent prognostic factor for HF in the training cohort [hazard ratio (HR) = 1.637, 95% confidence interval (CI) = 1.201–2.231, P = 0.002], the validation cohort (HR = 1.54, 95% CI = 1.051–2.257, P = 0.027), the PSM cohort (HR = 1.645, 95% CI = 1.273–2.125, P < 0.001), and the independent cohort (HR = 1.987, 95% CI = 1.251–3.155, P = 0.004). Conclusions Serum ApoB/ApoA‐I ratio is an independent predictor for the prognosis of HF patients.

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