Abstract: Objective To establish a prediction model of death risk in the elderly patients with chronic heart failure (CHF) treated with angiotensin receptor neprilysin inhibitors (ARNI), and to provide reference for early identification of high-risk patients with poor prognosis and formulation of more effective intervention programs. Methods A total of 183 elderly patients with CHF who received ARNI treatment in the First Hospital of Handan from January 2018 to January 2020 were retrospectively enrolled in this study, and were divided into death group (n=50) and survival group (n=133) according to the results of 3 years follow-up. The independent risk factors for death in elderly patients with CHF treated with ARNI were assessed by multivariate Cox regression analysis, and a prediction model of death risk was established. Results The median survival time of all patients was 25.0(22.0,34.0)months. The 1-year, 2-year, 3-year survival rate was 93.44% (171/183), 82.51% (151/183) and 72.68% (133/183), respectively. The results of multiple Cox regression analysis showed that left ventricular ejection fraction, left ventricular end-diastolic diameter, the levels of N-terminal pro-B-type natriuretic peptide and troponin Ⅰ were related to prognosis (P<0.05). ROC curve showed that the area under the curve of nomogram model predicting the 1-year, 2-year, 3-year survival rate was 0.741, 0.862 and 0.730, respectively. Conclusions The death risk of the elderly patients with CHF treated with ARNI may be related to a variety of cardiac structural and functional indicators. The model based on cardiac structural and functional indicators is more suitable in predicting the death risk of the patients.

Key words: angiotensin receptor enkephalase inhibitors, aged, chronic heart failure, cardiac structure, cardiac function