High-Mobility Group Box Protein 1 Is an Independent Prognostic Marker for All-Cause Mortality in Patients With Dilated Cardiomyopathy

High-mobility group box protein 1 (HMGB1) is released during tissue damage and activates the innate immune system through toll-like receptor 4. Because mortality in dilated cardiomyopathy (DCM) is associated with activation of the innate immune system, we hypothesized that HMGB1 possesses a prognostic value in estimating mortality in patients with DCM. We determined HMGB1 and N-terminal B-type natriuretic peptide (NTproBNP) levels in 67 patients with DCM (12 women, mean age 53.6 +/- 1.5 years). Kaplan - Meier analyzes revealed that higher levels of HMGB1 and NT-proBNP are related to increased all-cause mortality. Multivariable Cox regression confirmed HMGB1 as a risk factor for mortality in patients with DCM, independent of NT-proBNP, age, and gender (hazard ratio per 1 SD 1.920, 95% confidence interval 1.401 to 2.631, p < 0.001). HMGB1 is a promising candidate to estimate the prognosis of patients with DCM. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study found that the levels of HMGB1 were associated with increased mortality in patients with dilated cardiomyopathy. Multivariable Cox regression analysis confirmed HMGB1 as a risk factor for mortality in DCM patients, independent of NT-proBNP, age, and gender.