The Level of Apolipoprotein A-I Is Associated with a Prognosis in Patients with Chronic Heart Failure Especially in

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Updated: Sep 9, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

213

XueChun He1, FaPeng Li2, Jian Zhang1

  • 1Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, People's Republic of China.

International Journal of General Medicine
|September 2, 2025
PubMed

Insights

Low apolipoprotein A-I (ApoA-I) levels predict increased all-cause mortality (ACM) in chronic heart failure (CHF) patients. This association was significant in heart failure with mid-range (HFmrEF) and preserved ejection fraction (HFpEF) subtypes.

Area of Science:

  • Cardiology
  • Biomarkers
  • Prognostics

Background:

  • Chronic heart failure (CHF) poses a significant global health burden.
  • Identifying reliable prognostic markers is crucial for managing CHF patients.
  • Apolipoprotein A-I (ApoA-I) is a key component of high-density lipoprotein (HDL) and plays a role in reverse cholesterol transport.

Purpose of the Study:

  • To investigate the predictive value and prognostic significance of apolipoprotein A-I (ApoA-I) in patients with chronic heart failure (CHF).
  • To assess the association between ApoA-I levels and all-cause mortality (ACM) in different subtypes of CHF.

Main Methods:

  • A cohort of 4442 CHF patients was followed for a mean of 22.75 months.
  • Patients were categorized into low and high ApoA-I groups based on ROC curve analysis.
  • Multivariate Cox regression analysis was employed to determine the risk of ACM.

Main Results:

  • Lower ApoA-I levels were significantly associated with an increased risk of ACM in the overall CHF cohort (HR=0.702, P <0.001).
  • This association remained significant in patients with heart failure with mid-range ejection fraction (HFmrEF) (HR=0.443, P <0.001) and heart failure with preserved ejection fraction (HFpEF) (HR=0.704, P = 0.010).
  • No significant association was found between ApoA-I levels and ACM in patients with heart failure with reduced ejection fraction (HFrEF) (HR=0.806, P = 0.194).

Conclusions:

  • Apolipoprotein A-I concentrations are significantly associated with all-cause mortality in CHF patients.
  • The prognostic value of ApoA-I is particularly notable in HFmrEF and HFpEF.
  • ApoA-I may serve as a valuable biomarker for risk stratification in specific CHF populations.
Abstract

Keywords:
all-cause mortalityapolipoprotein A-Ichronic heart failurelipoprotein metabolism

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