Prognostic value of FSTL-1 combined with ALBI score in predicting patients with acute decompensated left heart failure in ICU

Yao Wensi; Wang Qingping; Jiang Yuxin; Shao Li; Liu Yuhao; Yao Zhixiang

doi:10.3969/j.issn.1002-1949.2026.03.010

Abstract：Objective To investigate the value of follistatin-like protein 1(FSTL-1)combined with albumin-bilirubin(ALBI)score in predicting the prognosis of patients with acute decompensated left heart failure in intensive care unit(ICU).Methods A total of 330 patients with acute decompensated left heart failure in ICU of Xuzhou Mining Group General Hospital from June 2022 to May 2025 were prospectively selected as the research objects.According to the admission and death of heart failure 3 months after discharge as the criteria for poor prognosis,the patients were divided into poor prognosis group and good prognosis group.The serum FSTL-1 level of the two groups was detected,and the ALBI score was calculated.Logistic regression equation was used to analyze the prognostic factors of patients with acute decompensated left heart failure in ICU.The receiver operating characteristic(ROC)curve was drawn to analyze the prognostic value of FSTL-1 combined with ALBI score in patients with acute decompensated left heart failure in ICU,and external verification was performed in another 105 patients with acute decompensated left heart failure from Xuzhou First People's Hospital.Results Three months after discharge,a total of 50 patients were admitted to hospital with heart failure again,and 25 patients died.The scores of NT-proBNP,cTnI,LAD,FSTL-1 and ALBI in the poor prognosis group were higher than those in the good prognosis group,and LVEF was lower than that in the good prognosis group(P<0.05).NT-proBNP,cTnI,LVEF,LAD,FSTL-1 and ALBI scores were all adverse prognostic factors in patients with acute decompensated left heart failure(P<0.05).The AUC of FSTL-1 and ALBI score in predicting the prognosis of patients was 0.743 and 0.767,which was not significantly different from that of NT-proBNP,cTnI,LVEF and LAD(P>0.05).The AUC of FSTL-1 combined with ALBI score in predicting the prognosis of patients with acute decompensated left heart failure was 0.855,which was significantly higher than that of single prediction(P<0.05).The AUC of the combined model of FSTL-1 and ALBI score in the external validation set was 0.856,and the accuracy was 83.81%.Conclusions The combination of FSTL-1 and ALBI score has high prognostic efficacy for acute decompensated left heart failure in ICU.The combination of the two can help to achieve early warning and guide the selection of individualized treatment strategies.