Abstract:

Objective To investigate the correlations between the ratio of C-reactive protein（CRP） to prealbumin（PA） and the prognosis of patients with acute heart failure（AHF）. Methods A total of 79 patients with AHF treated at the Affiliated Hospital of Traditional Chinese Medicine of Shanghai University of Traditional Chinese Medicine were enrolled retrospectively. The clinical data and laboratory determination results at admission were collected. All the patients were followed with an end date of January 2021 and a primary outcome of all-cause mortality. The optimal cut-off value of CRP/PA to predict AHF patient mortality was determined by receiver operating characteristic（ROC） curve. Pearson correlation analysis was used to determine the correlation between CRP and PA. Patient survival was evaluated by Kaplan-Meier survival curve and Log-rank χ² test. Risk factors for all-cause mortality were identified by Cox proportional hazard ratio. Results Pearson correlation analysis showed that CRP was negatively correlated with PA（r=-0.37，P=0.001）. The results of ROC curve analysis showed that the area under curve of CRP/PA to predict AHF mortality was 0.74 with an optimal cut-off value of 0.119 9. The patients were classified into CRP/PA ≤0.119 9 group（36 cases） and CRP/PA >0.119 9 group（43 cases） according to the optimal cut-off value. Kaplan-Meier survival curve analysis showed that the survival rate of CRP/PA ≤0.119 9 group was higher than that of CRP/PA >0.119 9 group（Log-rank χ²=22.27，P<0.001）. Cox regression analysis showed that after adjusting for age，sex，left ventricular ejection fraction（LVEF），serum creatinine（SCr），B-type natriuretic peptide（BNP），history of diabetes mellitus，diastolic blood pressure，total bilirubin（TB） and albumin（Alb），patients with CRP/PA >0.119 9 had a 9.03-fold increased risk of mortality than those with CRP/PA ≤0.119 9 [hazard ratio（HR）=9.03，95% confidence interval（CI） 2.88-28.29]. Conclusions High CRP/PA is related to all-cause mortality in patients with AHF，and it is helpful for risk stratification.

Key words: C-reactive protein, Prealbumin, Ratio of C-reactive protein to prealbumin, Acute heart failure, All-cause mortality