Heart failure (HF) is the end stage of a variety of cardiovascular diseases, high incidence, poor prognosis, seriously affect the quality of life of patients. The atherogenic index of plasma (AIP) is closely related to atherosclerosis, coronary heart disease and other cardiovascular diseases, and atherosclerosis is an important risk factor for heart failure.

To investigate the effect of the AIP index on the risk of new-onset HF.

This is a retrospective cohort study. 99 755 active and retired employees of Kailuan Group who participated in the health examination of the 11 hospitals affiliated to Kailuan General Hospital from June 2006 to October 2007 were selected as the observation population, and the subjects were divided into 4 groups according to baseline AIP quartile, namely Group Q1: AIP <-0.56 (n=24 937) ; Group Q2: -0.56≤AIP <-0.16 (n=24 940) ; Group Q3: -0.16≤AIP <0.31 (n=24 938) ; Group Q4: AIP≥0.31 (n=24 940). Follow-up continued until 31 December 2021, during which the incidence of HF was recorded once a year. The incidence density of HF in the 4 groups was calculated. The cumulative incidence of HF in the 4 groups was calculated using the Kaplan-Meier method. The effect of AIP on the risk of new-onset HF was analysed by Cox regression.

During a mean follow-up of 14.07 (13.79, 14.24) years, there were 3 337 (3.35%) cases of new HF. There were 675, 734, 940 and 988 cases in group Q1-Q4, respectively, and the incidence density was 1.95/1 000, 2.13/1 000, 2.73/1 000 and 2.87/1 000 years, respectively. The cumulative incidence of new HF in the Q1-Q4 group was 2.47%, 2.68%, 3.48% and 3.63%, respectively. According to the Log-rank test, the differences were statistically significant (χ²=76.90, P<0.001). In multivariate Cox regression analysis, compared with Q1, the risk for new-onset HF in Q3 and Q4 was 1.16 (95%CI=1.05-1.28) and 1.20 (95%CI=1.08-1.33), respectively, and the differences were statistically significant (P<0.05) .

AIP is an independent risk factor for new-onset HF, and the risk of new HF increases with the increase of AIP level. Early screening and evaluation of patients at high risk of HF can be achieved through AIP.

心力衰竭是多种心血管疾病的终末阶段，发病率高、预后差，严重影响患者生活质量。血浆致动脉硬化指数（AIP）与动脉粥样硬化、冠状动脉粥样硬化性心脏病等心血管疾病密切相关，而动脉粥样硬化是心力衰竭的重要危险因素。

探讨AIP对新发心力衰竭风险的影响。

本研究为回顾性队列研究，将2006年6月—2007年10月在开滦总医院及其附属医院共11家医院健康查体的99 755例开滦集团在职及离退休职工作为观察人群，根据基线AIP四分位数将研究对象分为4组，即Q1组：AIP <-0.56（n=24 937）；Q2组：-0.56≤AIP <-0.16（n=24 940）；Q3组：-0.16≤AIP <0.31（n=24 938）；Q4组：AIP≥0.31（n=24 940）。随访至2021-12-31，随访期间每年记录1次心力衰竭的发病情况。计算4组心力衰竭发病密度，根据Kaplan-Meier法计算4组心力衰竭累积发病率，采用多因素Cox回归分析AIP对新发心力衰竭风险的影响。

平均随访14.07（13.79，14.24）年，共新发心力衰竭3 337例（3.35%），Q1组、Q2组、Q3组、Q4组分别发生675、734、940、988例，发病密度依次为1.95、2.13、2.73、2.87千人年，累积发病率分别为2.47%、2.68%、3.48%和3.63%。Log-rank检验结果显示，4组累积发病率比较，差异有统计学意义（χ²=76.90，P<0.001）。多因素Cox回归分析结果显示，与Q1组相比，Q3组、Q4组新发心力衰竭的风险分别为1.16（95%CI=1.05~1.28，P<0.05）和1.20（95%CI=1.08~1.33，P<0.05）。

AIP升高是新发心力衰竭的独立危险因素，随着AIP增高，新发心力衰竭的风险亦随之增高。通过AIP可实现对心力衰竭高风险患者进行早期筛查与评估。