ObjectiveTo investigate the correlation between the aspartate aminotransferase to alanine aminotransferase ratio (AAR) and the long-term prognosis of patients with heart failure with preserved ejection fraction (HFpEF) who are admitted to the intensive care unit (ICU). MethodsA total of 1 228 HFpEF patients admitted to the ICU from 2001 to 2012 were included in the analysis from the MIMIC-Ⅲ database. According to the optimal cut-off value of AAR, the patients were divided into a high AAR group (AAR ≥1.42) and a low AAR group (AAR＜1.42) by the X-tile software, and the clinical data between the two groups were compared. A Kaplan-Meier survival curve was plotted with 1-year all-cause mortality after ICU admission as the endpoint event, and a Cox proportional hazard regression model was used to analyze the correlation between AAR and 1-year all-cause mortality after ICU admission in HFpEF patients. ResultsCompared to the low AAR group, the high AAR group had higher age, proportions of patients with chronic obstructive pulmonary disease, hypothyroidism and atrial fibrillation/atrial flutter, and serum creatinine level，as well as lower body weight, BMI, systolic blood pressure, hemoglobin level and proportion of diuretic use, with statistically significant differences (all P＜0.05). The result of Log-Rank test showed that the survival rate of HFpEF patients in the high AAR group was lower than that of the low AAR group, with statistically significant difference (P＜0.05). The result of Cox multivariate analysis showed that AAR, age, BMI, systolic blood pressure, and use of diuretic were independent influencing factors for all-cause mortality within 1-year from the day of ICU admission in HFpEF patients (all P＜0.05）. ConclusionIn order to reduce the mortality of HFpEF patients, targeted therapeutic intervention should be carried out according to the independent factors of 1-year all-cause mortality after ICU admission.

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