AIM  To investigate the predictive value of high sensitive cardiac troponin I (Hs-cTnI) and coronary artery calcification score (CACS) using spiral CT in patients with heart failure with preserved ejection fraction (HFpEF).

  METHODS  We retrospectively analyzed HFpEF patients in our hospital from January 2017 to December 2019. The occurrence of adverse events was recorded via telephone follow-up. A total of 235 HFpEF patients were collected, 16 were lost to follow-up, and 219 were included. The follow-up time was (40±21) months. A total of 80 all-cause deaths occurred and 56 were cardiac death. Single-factor analysis and multi-factor analysis were carried out through COX regression model, and indicators that had predictive value for HFpEF death were obtained. Finally, receiver operating characteristic curve (ROC) was used to analyze the predictive value of CACS and Hs-cTnI for death of HFpEF patients.

  RESULTS  CACS classification, Hs-cTnI and brain natriuretic peptide (BNP) levels were positively correlated (r=0.3081, P<0.05 and r=0.7081, P<0.05); Multivariate COX regression showed that BNP, CACS and Hs-cTnI were independent predictors for the occurrence of all-cause death and cardiac death in patients with HFpEF patients (P<0.05). ROC analysis showed that the AUC value, sensitivity and specificity of combining CACS and Hs-cTnI for adverse events in HFpEF patients were higher than those of one individual predictor.

  CONCLUSION  Hs-cTnI and CACS are good predictors for all-cause death and cardiovascular death in patients with HFpEF, and Hs-cTnI combined with CaCS has higher predictive value.