The Role of the Lactate-to-Albumin Ratio in Predicting In-Hospital Mortality in Patients with Heart Failure with Preserved Ejection Fraction Presenting to the Emergency Department

Abstract Background Heart failure with preserved ejection fraction (HFpEF) is an important form of heart failure associated with high mortality rates. Identifying risk factors is crucial for improving hospital mortality rates. The lactate/albumin ratio (LAR) has been found to be associated with adverse clinical outcomes in conditions such as sepsis and myocardial infarction. In this study, we aim to evaluate the potential of LAR as a prognostic marker for mortality in patients with HFpEF. Methods In this retrospective study, patients diagnosed with HFpEF were included. Data from patients who were admitted to the emergency department or cardiology clinic between January 1, 2023, and June 1, 2024, were used from the hospital information system database. Results A total of 503 patients were included in the study, of whom 74 died during hospitalization. Univariate and multivariate Cox regression analyses were performed to determine the relationship between LAR at admission and hospital mortality. The LAR value was significantly higher in the group of patients who died during hospitalization compared to survivors (0.07 vs 0.05, p < 0.05). The area under the ROC curve was 0.636 (95% CI: 0.520–0.752), and the optimal cut-off value for LAR was 0.48. Conclusion An elevated LAR is significantly associated with mortality in HFpEF and can be used as an early prognostic marker for mortality in these patients.