Circulating high-mobility group box 1 and cardiovascular mortality in unstable angina and non-ST-segment elevation myocardial infarction

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• 作者：Tousei Hashimoto^a ; Junnichi Ishii^b ; ^{jishii@fujita-hu.ac.jp} ; Fumihiko Kitagawa^b ; Shingo Yamada^c ; Kousuke Hattori^a ; Masanori Okumura^a ; Hiroyuki Naruse^a ; Sadako Motoyama^a ; Shigeru Matsui^d ; Ikuko Tanaka^b ; Hideo Izawa^a ; Ikuro Maruyama^e ; Masanori Nomura^a ; Yukio Ozaki^a
• 关键词：High-mobility group box 1 ; High-sensitivity C-reactive protein ; Cardiac troponin I ; Cardiovascular mortality ; Unstable angina and non-ST-segment elevation myocardial infarction
• 刊名：Atherosclerosis
• 出版年：2012
• 期刊代码：28_00219150
• 类别：med
• 出版时间：April, 2012
• 卷：221
• 期：2
• 页码：490-495
• 文件大小：328 K

摘要

Objective

High-mobility group box 1 (HMGB1) is a damage-associated molecular pattern molecule, which suggests a potential role of this protein in the pathophysiology of acute coronary syndrome (ACS). Circulating HMGB1 has been shown to be independently associated with cardiac mortality in ST-segment elevation myocardial infarction. However, its prognostic value remains unclear in unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI).

Methods

HMGB1, high-sensitivity C-reactive protein (hsCRP), cardiac troponin I and B-type natriuretic peptide concentrations were measured on admission in 258 consecutive patients (mean age of 67 years) hospitalized for UA/NSTEMI within 24 h (mean, 7.4 h) of the onset of chest symptoms.

Results

A total of 38 (14.7%) cardiovascular deaths, including 10 in-hospital deaths, occurred during a median follow-up period of 49 months after admission. In a stepwise Cox regression analysis including 19 well-known clinical predictors of ACS, HMGB1 [relative risk (RR) 3.24 per 10-fold increment; P = 0.0003], cardiac troponin I (RR 1.83 per 10-fold increment, P = 0.0007), Killip class > 1 (RR 4.67, P = 0.0001) and age (RR 1.05 per 1-year increment, P = 0.03), but not hsCRP, were independently associated with cardiovascular mortality. In-hospital and cardiovascular mortality rates were higher in patients with increased HMGB1 (鈮?.4 ng/mL of median value) than those without increased HMGB1 (6.3%vs. 1.5%, P = 0.04; and 23%vs. 6.9%, P = 0.0003).

Conclusion

Circulating concentration of HMGB1 on admission may be a potential and independent predictor of cardiovascular mortality in patients hospitalized for UA/NSTEMI within 24 h of onset.