Abstract:Objective: To investigate the influence of apolipoprotein AⅠ (apoAⅠ) at admission on the prognosis of patients with pulmonary embolism (PE). Methods: A total of 161 patients who were hospitalized with initial diagnosis of PE in our hospital from August 1, 2013 to August 15, 2019 were retrospectively screened. The receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off value of apoA I and patients were divided respectively into 2 groups which contained the low level group and the high level group. Follow-up was started with the admission time, and the deadline was September 15, 2019. The end-event was all-cause death. Kaplan-Meier method was applied to draw the survival curves and log-rank test was used to compare two curves. Univariate and multivariate Cox proportional hazards regression model analysis was used to analyze variables included apoAⅠwhich potentially influenced the prognosis. Results: During the follow-up period, 39 patients died by all-cause, with fatality rate of 24.22%. The optimal cut-off of ROC was 0.965 g/L and the area under the curve (AUC) was 0.716 (95%CI=0.616-0.815). The cases of dead patients in the high level apoAⅠgroup (≥0.965 g/L, n=112), and low level apoAⅠgroup (<0.965 g/L, n=49) were 15 and 24, respectively. The fatality rate of patients in the low level group was 48.98%and in the high level group was 13.39%. Univariate Cox proportional hazards regression model analysis showed that age, total cholesterol, malignant tumor, the use of statins and the level of apoAⅠhad significance to prognosis of patients (P<0.2). Multivariate Cox proportional hazards regression model analysis concluded that age (P=0.001), the use of statins (P=0.003), malignant tumor (P=0.001) and level of apoAⅠ (P=0.004) were independent factors influencing PE prognosis, indicating that apoAⅠ<0.965 g/L was of predictive value to the prognosis of patients with PE. Log-rank test indicated that survival rate in the low level group was significantly lower than that in the high level group, with statistically significant difference (P=0.000). Conclusion: The decrease of apoAⅠlevel detected in admission is related with the increase of mortality risk, which can predict the prognosis of patients with PE.
