Abstract 4337300: Evaluating the Atherogenic Index of Plasma as a Prognostic Indicator for Readmission Risk in Heart Failure Patients: A Retrospective Cohort Study

Aims: Among patients who are hospitalized with heart failure (HF), about 50% have readmissions within 6 months. The impact of atherogenic index of plasma (AIP) and low-density lipoprotein cholesterol (LDL-C) on HF readmission risk is unclear. Our study aims to determine if there is an association between AIP, LDL-C and readmission rate for HF. Methods: We used a public dataset of patients hospitalized with a prior or new diagnosis of HF in Zigong Fourth People’s Hospital in China between 2016 to 2019 (https://doi.org/10.13026/5m60-vs44). AIP was categorized into <0.11 (normal risk), 0.11-0.21 (intermediate risk), and >0.21 (high risk). The association between AIP and 6-month readmission rate was explored through a Cox proportional hazard analysis with a crude model, one adjusted for age, gender, and BMI (Model 1), and one adjusted for additional variables such as type of HF, guideline-directed medical therapy, New York Heart Association cardiac function classification (fully adjusted model). The association between LDL- C tertile (≤1.46, 1.46<LDL-C≤2.1, >2.1 mmol/L) and readmission rate was also analyzed with the same adjustments. Competing risk analysis for mortality was done using the Fine-Gray model. Results: A total of 1805 patients were included. There was no significant association between AIP level and readmission rate in the crude model (HR 1.03, 95% CI 0.93-1.14), Model 1 (HR 1.05, 95% CI 0.95-1.17), fully adjusted model (HR 1.03, 95% CI 0.95-1.18), and the Fine-Gray model (HR 0.99, 95% CI 0.94-1.05). In contrast, the higher LDL-C tertile was associated with decreased readmission risk in the crude model (HR 0.87, 95% CI 0.79-0.96) and Model 1 (HR 0.89, 95% CI 0.80-0.97). This association was no longer statistically significant in the fully adjusted (HR 0.93, 95% CI 0.84-1.03) and Fine-Gray model (HR 1.02, 95% CI 0.97-1.08). Conclusion: In this Chinese cohort of hospitalized HF patients, we found no significant association between AIP levels and 6-month readmission rate, even after extensive clinical covariate adjustment and accounting for competing mortality risk. Lower LDL-C level showed a modest trend toward reduced readmission in unadjusted models but this association was not sustained after full adjustment. These findings suggest that AIP and LDL-C may have limited utility as independent predictors of 6-month HF readmission rates. Future research is warranted to evaluate the role of AIP and LDL-C level in long-term HF outcomes.