Correlation Between Serum Apolipoprotein A and Clinical Outcome in Patients with Non-ischemic Heart Failure

Previous studies on the correlation between serum apolipoprotein A-I (apoA-I) and the severity of heart failure (HF) as well as short-term clinical outcomes in patients with heart failure due to non-ischemic cardiomyopathy (NICM) have been inconclusive. To address this, we aimed to determine the impact of apoA-I on the severity of heart failure and short-term clinical outcomes in patients with HF due to NICM. In this single-center, observational study, we recruited 154 patients with NICM heart failure (NYHA functional class II-IV) and 80 control patients with normal cardiac function. Baseline characteristics were collected during hospitalization, and follow-up records were obtained 6 months after discharge. Statistical analyses included Pearson’s chi-squared test and Spearman's correlation analysis, while the receiver operating characteristic (ROC) curve was used to discriminate patients with severe heart failure. Results showed that serum apoA-I levels were significantly lower in the heart failure group compared to controls and decreased with increasing cardiac function class. Additionally, serum apoA-I was positively correlated with left ventricular ejection fraction (LVEF) and negatively correlated with B-type natriuretic peptide (BNP) and cardiac function class. Patients who experienced clinical events within 6 months of discharge had significantly lower apoA-I concentrations compared to those without events. In conclusion, low serum apoA-I concentrations in patients with NICM and heart failure may be associated with more severe heart failure and a higher probability of recurrent clinical events in the short term.