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"Objective To investigate the predictive value of hemoglobin glycation index (HGI) for endpoint events in patients with acute decompensated heart failure (ADHF). Methods A total of 1 420 patients with ADHF who were admitted to the Department of Cardiology, Nanjing Drum Tower Hospital from September 1, 2010, to September 1, 2019, were included in this study, and the corresponding HGI values were calculated. The patients were divided into three groups based on the tertiles of HGI ［group T1（HGI≤0.499%， n=473），group T2（0.499%＜HGI≤1.108%， n=474），group T3（HGI＞1.108%， n=473）］. The endpoints included all-cause mortality, cardiovascular mortality, and major adverse cardiovascular and cerebrovascular events (MACCE). The occurrence rates of the endpoints in the three groups were evaluated by Kaplan-Meier curves, and the predictive value of HGI for the endpoints was assessed by the multivariable COX proportional hazards model. Results During a follow-up period of 60 months, all-cause mortality was 25.28%, cardiovascular mortality was 13.03%, and MACCE incidence rate was 58.59% in the study cohort. The adjusted Kaplan-Meier curves showed that all-cause mortality and cardiovascular mortality decreased with increasing HGI values (P＜0.05). There was no significant difference in incidence rate of MACCE among three groups (P>0.05). In the adjusted multivariate COX proportional hazaras model, the increase in HGI was significantly associated with a decrease in all-cause mortality (HR=0.501, 95%CI: 0.336-0.747, P=0.001) and cardiovascular mortality (HR=0.438, 95%CI: 0.255-0.754, P=0.003). Conclusion Increased HGI values are significantly associated with decreased all-cause mortality and cardiovascular mortality in patients with ADHF, but not with the occurrence of MACCE. "