Abstract: Objective To investigate the association of aspartate aminotransferase-to-platelet ratio index (APRI) with right heart function and major adverse cardiovascular events (MACE) in the elderly patients with heart failure with preserved ejection fraction (HFpEF). Methods A total of 115 elderly patients with HFpEF admitted to our hospital from January 2018 to June 2020 were retrospectively enrolled. All the patients were followed up for 12 months. According to whether MACE occurred during the follow-up period, they were divided into MACE group (n=36) and control group (n=79). The clinical data were collected. The correlation of APRI with right heart function indicators [tricuspid annular plane systolic excursion (TAPSE), tricuspid annulus peak systolic velocity (S′)], risk factors for MACE and the predictive value of APRI for MACE in the elderly patients 12 months after discharge were analyzed. Results The levels of APRI, total bilirubin (TBiL) and N-terminal pro-brain natriuretic peptide (NT-proBNP), and the proportion of atrial fibrillation and NYHA grade Ⅳ in MACE group were higher, and the levels of albumin (ALB), TAPSE, S′ and LVEF were lower than those in the control group (P<0.05). APRI was negatively correlated with TAPSE, S′ and LVEF in the elderly patients with HFpEF (r=-0.513, -0.438, -0.596; P<0.05). Atrial fibrillation, APRI and NT-proBNP were the independent influencing factors of MACE in the elderly patients with HFpEF 12 months after discharge (P<0.05). The area under the curve of APRI to predict MACE in the elderly patients with HFpEF 12 months after discharge was 0.779, and showed no significant difference from NT-proBNP (Z=0.653, P>0.05). Conclusions Increased APRI is associated with impaired right heart function and MACE in the elderly patients with HFpEF, which is a new potential prognostic index for elderly patients with HFpEF.

Key words: aspartate aminotransferase, platelet, left ventricular ejection fraction, heart failure, prognosis