2026-10-11T18:19:37Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33828529 2026-09-16T05:30:02Z category_140 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Association between the alkaline phosphatase-to-albumin ratio and recorded early all-cause mortality within 90 days of admission in patients with heart failure: a retrospective cohort study in a Chinese population.docx Zhenyu Yuan (2872487) Mohan Li (7527596) Lei Zhao (144153) Hong Geng (2179690) Qiang Ji (309652) Kun Zuo (3897997) Yuanzhi Luo (18833051) Guanli Liang (24961024) Gengxu He (24961027) Cardiology 90-day mortality alkaline phosphatase-to-albumin ratio early mortality heart failure risk marker Background<p>APAR combines alkaline phosphatase and albumin, two routine laboratory measurements. We examined its association with recorded early all-cause mortality within 90 days of admission in hospitalized patients with heart failure (HF), prioritizing continuous APAR over a mortality-derived cutoff.</p>Methods<p>We analyzed version 1.3 of the Zigong Heart Failure Database. Among 2,008 patients, 1,906 had calculable APAR and a recorded vital-status outcome within 90 days; 37 deaths were recorded. Exact event times were available for 1,905 patients (36 deaths). The primary model assessed standardized ln(APAR), adjusting for the eight released age categories as a 1–8 ordinal score, sex, log(BNP), eGFR, sodium, and CCI, with NYHA class stratification. Mortality timing, post-discharge survival, hemoglobin adjustment, and E-values were examined in sensitivity analyses.</p>Results<p>Recorded all-cause mortality within 90 days of admission was 1.94%. In the complete-case model (n = 1,824; 36 deaths), each 1-SD increase in ln(APAR) was associated with higher mortality (HR 1.375, 95% CI 1.024–1.846; P = 0.034), whereas raw APAR per 1 U/g was not (HR 1.146, 95% CI 0.988–1.330; P = 0.072). The spline showed an overall association (P = 0.025) and nonlinearity (P = 0.023). Nine of 37 deaths were confirmed in-hospital. Among 1,897 patients discharged without recorded in-hospital death, 28 died within 90 days: 15 on a later calendar date, 12 on the discharge date, and one with missing exact timing. In the strict post-discharge analysis, the adjusted HR was 1.460 (95% CI 0.931–2.289; P = 0.099; 15 events). APAR showed modest discrimination (AUC 0.698), while incremental value was limited: ΔC-index 0.018 (P = 0.104), IDI 0.0019 (95% CI −0.0035 to 0.0252), small decision-curve gains, and continuous NRI 0.179 (95% CI −0.129 to 0.577).</p>Conclusion<p>Higher admission ln(APAR) was associated with recorded early all-cause mortality within 90 days of admission, but the association was modest, nonlinear, scale-dependent, and based on few events. Post-discharge estimates were directionally consistent but imprecise. External validation is required before APAR or any cutoff is used for clinical risk stratification.</p> 2026-09-16T05:30:02Z Dataset Dataset 10.3389/fcvm.2026.1936612.s001 https://figshare.com/articles/dataset/Supplementary_file_1_Association_between_the_alkaline_phosphatase-to-albumin_ratio_and_recorded_early_all-cause_mortality_within_90_days_of_admission_in_patients_with_heart_failure_a_retrospective_cohort_study_in_a_Chinese_population_docx/33828529 CC BY 4.0