Association between vascular adhesion protein-1 and major adverse cardiovascular events in heart failure patients: a retrospective cohort analysis

Vascular adhesion protein-1 (VAP-1), a multifunctional inflammatory mediator, has been implicated in cardiovascular pathology. Current evidence regarding its prognostic relevance in heart failure (HF) is incomplete. This investigation was designed to evaluate circulating VAP-1 as a biomarker for its association with HF progression susceptibility and its clinical prognostic value for adverse cardiovascular events. This retrospective observational cohort study included 356 individuals receiving treatment at Soochow University Hospital from May 2020 to September 2022, among whom 165 were diagnosed with heart failure. During the baseline evaluation, VAP-1 concentrations in blood serum were measured through ELISA testing. Major adverse cardiovascular events (MACE) were designated the principal study endpoints, with data collected from electronic health records and telephone follow-ups. Analytical methods incorporated multiple regression analysis, nonlinear modeling approaches, and Kaplan-Meier survival probability assessments. Additional analyses examined the association between heart failure progression and VAP-1 levels through multiple regression modeling, ROC curve assessment, and AUC calculations to establish VAP-1’s diagnostic potential for heart failure identification. When accounting for potential confounding factors, higher concentrations of VAP-1 showed a correlation with MACE in patients with HF (Q2 versus Q1: hazard ratios HR = 1.7, 95% confidence intervals CI = 0.71–4.12; Q3 versus Q1: HR = 2.85, 95% CI = 1.1–7.36). These results were further validated through survival probability assessments and non-linear regression modeling. Multiple regression analysis demonstrated that increased VAP-1 levels served as an independent risk factor for heart failure progression (P = 0.0271, HR = 1.0012, 95% CI = 1.0001–1.0022). The study demonstrates a meaningful relationship between heightened VAP-1 concentrations and both the development of heart failure and cardiovascular complications, indicating VAP-1’s possible utility as a diagnostic marker for assessing heart failure risk and clinical outcomes.