Predictive value of combined detection of Lp(a),HDL-C,and ApoA1 in patients with heart failure for prognosis
Objective:To explore the value of combining lipoprotein(a)[Lp(a)],high-density lipoprotein cholesterol(HDL-C),and apolipoprotein A(ApoA)in predicting the prognosis of heart failure patients.Methods:160 patients with heart failure who visited our hospital from January 2020 to January 2022 were selected as the study group,and 40 healthy individuals who underwent physical examinations at our hospital during the same period were selected as the control group.The levels of Lp(a),HDL-C,and ApoA were compared between the two groups.Follow up patients for a period of one year,and divide the study group into a good prognosis group and a poor prognosis group based on whether major adverse cardiovascular events(MACE)have occurred.Compare the differences in clinical indicators,Lp(a),HDL-C,and ApoA levels among heart failure patients with different prognoses;Logistic regression analysis of factors influencing poor prognosis in patients with heart failure;Draw ROC curves to analyze the predictive value of the above indicators for the prognosis of heart failure patients.Results:The Lp(a)levels of patients in the study group were higher than those in the control group,but their HDL-C and ApoA levels were lower than those in the control group(P<0.05).At the level of Lp(a),the NYHA classification is level II<level III<level IV(P<0.05);In comparison of HDL-C and ApoA levels,the NYHA classification is level II>level III>level IV(P<0.05).In this study,160 patients with heart failure were followed up for 1 year.Among them,120 had a good prognosis and 40 had a poor prognosis.NYHA grade IV,Lp(a),HDL-C,and ApoA were all risk factors for poor prognosis in heart failure patients(P<0.05).The AUC for diagnosing poor prognosis in heart failure patients with Lp(a)is 0.843(95%CI,0.777-0.896);The AUC with poor prognosis in HDL-C diagnosis of heart failure patients is 0.784(95%CI,0.712-0.845);The AUC for poor prognosis in patients with heart failure diagnosed by ApoA is 0.783(95%CI,0.710-0.844);The AUC of poor prognosis in patients with heart failure diagnosed by the combination of the three indicators was 0.913(95%CI,0.858-0.952),which was higher than the diagnostic efficacy of various single indicators(Z=3.087,3.619,3.233,P<0.05).Conclusion:The serum Lp(a)in patients with heart failure is abnormally elevated,while HDL-C and ApoA are abnormally reduced.The combined detection of the three has high predictive value for the prognosis of heart failure patients.
Heart failureLipoprotein(a)High density lipoprotein cholesterolApolipoprotein APrognosisAdverse cardiovascular events
万方数据
维普
