The Prognosis of Prothrombin Activity in Patients with Heart Failure

Abstract Background: Patients with heart failure frequently exhibit coagulation dysfunction and abnormal liver function. Prothrombin activity (PTA) serves as a sensitive indicator to assess these irregularities. Thus, our objective was to assess the prognostic significance of PTA in risk assessment for heart failure. Method: The database is sourced from this paper 1 . In this retrospective cohort study, it recruited 2008 patients with heart failure admitted to Zigong Fourth People’s Hospital between December 2016 to June 2019. Demographic data, medical history, Charlson score at admission, Glasgow coma score(GCS) and their first blood samples after admission were all collected, including biochemical electrolytes, coagulation function, liver and kidney function, jaundice routine, blood analysis, and blood gas analysis. These patients were followed up for six months. The primary end point of follow-up was all-cause death, and the secondary end point was readmission within six months. Results: In this retrospective cohort study, the all-cause mortality rate was 2.1% (n=42) at six months. Significant differences were observed between the fatal and non-fatal groups in terms of PTA and the proportion of patients with grade IV cardiac function. PTA demonstrated promising potential as a predictor of all-cause mortality, with an optimal threshold of 60.94 (p<0.001). Kaplan-Meier analysis demonstrated lower survival and higher re-hospitalization rates in patients with PTA≤60.94. Multivariate analyses identified creatinine, D-dimer, AST, GCS, and PTA≤60.94[OR3.990(1.551-10.263), P=0.004] as independent predictors of mortality. For re-hospitalization, PTA≤60.94 [OR1.814(1.436-2.292), P＜0.001] were remain an independent predictor. Conclusion: Prothrombin activity provides powerful prognostic information for patients with heart failure.