Prognostic significance of serum laminin and the Zhejiang University index in patients with acute heart failure

This study was conducted to evaluate the prognostic utility of serum laminin (LN) and the Zhejiang University (ZJU) index in patients diagnosed with acute heart failure (AHF). A retrospective analysis was conducted involving 300 patients with AHF who were admitted to the Department of Cardiology at Nantong First People’s Hospital between July 2019 and November 2020. The cohort was stratified into two groups: a de novo acute heart failure (DNHF) group and an acute decompensated heart failure (ADHF) group. Baseline clinical and laboratory characteristics were documented, and compared between the two groups. Major adverse cardiovascular events (MACE) served as the primary observational endpoint. Linear relationships were verified by Box-Tidwell test, multicollinearity was diagnosed by linear regression model for continuous variables. Based on the occurrence of MACE during follow-up, the study population was further categorized into an event group and a non-event group, and comparative analyses were conducted between these groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of serum LN, the ZJU index, and their combined model for MACE in patients with AHF. Multivariate logistic regression analysis was subsequently applied to determine independent predictors associated with the occurrence of MACE. Among the 300 patients with AHF, 150 were classified as having DNHF and 150 as having ADHF. Statistically significant differences were observed between the two groups with respect to N-terminal pro-brain natriuretic peptide (NT-proBNP), serum LN levels, left ventricular ejection fractions, and the ZJU index ( p < 0.05). During the follow-up period, 68 patients experienced MACE. Multivariate logistic regression analysis identified elevated NT-proBNP concentration, increased serum LN levels, and a higher ZJU index as independent risk factors associated with MACE. ROC curve analysis demonstrated that serum LN predicted MACE in patients with AHF with an area under the curve (AUC) of 0.721. The optimal cutoff value was 67.045 ng/mL, yielding a sensitivity of 78.8% and a specificity of 53.7% ( p < 0.001). The ZJU index demonstrated an AUC of 0.733, with a cutoff value of 32.345, sensitivity of 78.8%, and specificity of 56% ( p < 0.001). The combined model incorporating LN and the ZJU index demonstrated improved predictive performance, with an AUC of 0.806,sensitivity of 83.8%, and specificity of 73.6% ( p < 0.001). Serum laminin concentration, the ZJU index, and their combined assessment demonstrate potential prognostic value for predicting major adverse cardiovascular events in patients with acute heart failure.