OBJECTIVE: The present study aimed to explore the predictive value and prognosis of apolipoprotein A-I (ApoA-I) in chronic heart failure (CHF) patients. METHODS: We recruited 4442 patients with CHF who were admitted to The First Affiliated Hospital of Xinjiang University Medical University with a period of ten years from July 2012, and the mean follow-up time was 22.75 months. The endpoints were defined as all-cause mortality (ACM), the patients divided into low and high ApoA-I groups according to the optimal cutoff value of the ROC curve from finally analyzed HF patients. RESULTS: In the whole follow-up periods, multivariate Cox regression analysis showed that total CHF patients in low ApoA-I groups had significantly increased risk of ACM as compared with patients in the high ApoA-I group (hazard ratio [HR]=0.702, 95%confidence interval [CI]: 0.603-0.817, P <0.001). This trend was consistent in patients with heart failure with mid-range (HFmrEF) (HR = 0.443, 95% CI: 0.298-0.658, P <0.001) and heart failure with preserved ejection fraction (HFpEF) (HR = 0.704, 95% CI: 0.539-0.919, P = 0.010), but not in heart failure with reduced ejection fraction (HFrEF) (HR = 0.806, 95% CI: 0.582-1.116, P = 0.194). CONCLUSION: The Apolipoprotein A-I concentrations significantly associated with ACM of CHF especially in HFmrEF and HFpEF.