Abstract: Objective To explore the impact of social frailty (SF) on long-term prognosis in the elderly patients with stable chronic heart failure(CHF). Methods A total of 215 patients with stable CHF who met the inclusion and exclusion criteria from January 1, 2022 to June 30, 2024 were selected as the research subjects. All the patients received standardized guideline-directed drug therapy and rehabilitation. The general clinical data of the patients were recorded and SF was evaluated using the Help, Participation, Loneliness, Financial, Talk (HALFT) scale. The patients were followed up, with the endpoint event being major adverse cardiovascular events (MACE), and the follow-up was terminated on June 30, 2025. Survival curves and Cox regression were used to explore the impact of SF on MACE. Results Among the 215 patients, 126 had SF, with a prevalence rate of 58.6%. The 1-year and 3-year MACE-free survival rates in the SF group were 84.1% and 60.5%, while those in the non-SF group were 89.9% and 76.6%, respectively. Kaplan-Meier curve analysis showed that there was a statistically significant difference in the MACE-free survival curves between the SF group and the non-SF group (χ²=4.425, P=0.035). After adjusting for comorbidities, NYHA heart function classification, N-terminal pro-B-type natriuretic peptide, and left ventricular ejection fraction in the multivariate Cox regression, SF was found to be an independent risk factor for MACE. Conclusions SF is common in elderly CHF patients and is an independent risk factor for adverse cardiovascular outcomes in stable CHF patients.

Key words: chronic heart failure, aged, social frailty, prognosis