BACKGROUND: Plasma ghrelin levels can be elevated in patients with acute heart 
failure (AHF). This study aimed to analyze the temporal changes and prognostic 
value of ghrelin levels in patients with AHF.
METHODS: This prospective study included patients with AHF at the Cardiology 
Department, Weifang People's Hospital (May 2018-October 2019), and age- and 
sex-matched healthy controls. Plasma ghrelin levels were measured. Multivariable 
logistic regression and receiver operating characteristic (ROC) curve analyses 
were used to evaluate whether ghrelin levels could predict major cardiac adverse 
events (MACEs) during a 1-year follow-up.
RESULTS: Finally, 92 patients with AHF and 50 healthy controls were enrolled. 
Ghrelin levels were higher in patients with AHF at 1, 3, 12, and 24 h compared 
with controls (all P < 0.01). Ghrelin levels in the AHF group were higher at 3 
and 12 h than at 1 and 24 h (P < 0.001). Ghrelin level at 3 h in patients with 
AHF was negatively correlated with the left ventricular end-diastolic diameter 
and left ventricular ejection fraction (both P < 0.05). MACEs occurred in 48 
patients with AHF. Ghrelin levels were higher in the MACE group than in the 
non-MACE group at 1 (P = 0.011) and 3 h (P = 0.034). Multivariable regression 
showed that ghrelin level at 3 h was independently associated with MACEs 
[OR = 0.629, 95% confidence interval (CI): 0.515-0.742, P = 0.010], but the area 
under the ROC curve was only 0.629 (95% CI 0.515-0.742).
CONCLUSIONS: Plasma ghrelin levels are elevated in AHF and patients with MACEs 
during follow-up.