title: Plasma high-mobility group box 1 levels predict mortality after ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  We evaluated the potential association between plasma high-mobility group box 1 (HMGB1) levels and outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention.
  
  
  BACKGROUND
  The positive effect of reperfusion after STEMI may be compromised by ischemic/reperfusion injury. HMGB1 is released by necrotic cells and, in pre-clinical studies, has been implicated to play a role in myocardial ischemic/reperfusion injury.
  
  
  METHODS
  The study included 141 STEMI patients, with acute occlusion of the left anterior descending coronary artery successfully treated with percutaneous coronary intervention. Plasma HMGB1 levels were measured by enzyme-linked immunoadsorbent assay at admission. Forty-two healthy individuals served as control subjects.
  
  
  RESULTS
  After a median of 10 months of follow-up, 13 STEMI patients died. There were no significant differences with regard to baseline variables between the group of patients who survived and those who died. Baseline HMGB1 levels were increased in STEMI patients when compared with control subjects. Furthermore, the STEMI patients who died had higher HMGB1 levels than those who survived. After adjusting for age, sex, troponin I, and creatine kinase-myocardial band, we found that a doubling of HMGB1 concentrations increased the risk of mortality by 75% (hazard ratio: 1.75; 95% confidence interval: 1.1 to 2.8).
  
  
  CONCLUSIONS
  Plasma HMGB1 levels are elevated in STEMI patients compared with healthy control subjects. Furthermore, after a follow-up period of 10 months, plasma HMGB1 levels are shown to be independently associated with increased mortality in STEMI patients treated with PCI. These data suggest that plasma HMGB1 may be used as a new prognostic biomarker in STEMI patients.
authors: Medical Research Laboratories, Clinical Institute, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.
authors: Morten V
authors: MV
authors: Sørensen
authors: Sune
authors: S
authors: Pedersen
authors: Rasmus
authors: R
authors: Møgelvang
authors: Jan
authors: J
authors: Skov-Jensen
authors: Allan
authors: A
authors: Flyvbjerg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein