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Core 7. Vascular Disease: Biology and Clinical Science
Session Title: Advances in Human Atherosclerosis and Stenosis

Abstract 14419: HMGB1 — A Predictor for Infarct Transmurality and Functional Recovery in Patients with Myocardial Infarction.

Originally publishedCirculation. 2010;122:A14419

    Background: The high-mobility group box 1 (HMGB1) protein is a newly recognized innate danger signal for the initiation of host defense and tissue repair. The aim of this project was to analyze HMGB1 blood levels and their association with infarct transmurality and functional recovery in patients with ST-elevation (STEMI) and non-ST elevation myocardial infarction (NSTEMI).

    Methods: We prospectively examined patients with first STEMI (n=46) and NSTEMI (n=49), treated according to current guidelines with primary angioplasty and stent placement. Contrast-enhanced cardiac magnetic resonance imaging (CMR) was performed 2–4 days after infarction for the estimation of infarct transmurality and was repeated at 6 months of follow-up for the estimation of residual left ventricular function. HMGB1 was measured 2–4 days after infarction in all patients.

    Results: Systemic HMGB1 expression was related to infarct size and to residual ejection fraction in patients with STEMI (r2=0.81 and r2=0.40, respectively, p<0.001 for both) and NSTEMI (r2=0.74 and r2=0.25, respectively, p<0.001 for both). Cut-off values of HMGB1=6.2ng/ml and 5.9ng/ml, respectively, were predictive of infarct transmurality≥75% (AUC=0.93; SE=0.04; 95%CI=0.81–0.98 for STEMI and AUC=0.96; SE=0.04; 95%CI=0.86–0.99 for NSTEMI) and similar cut-off values of HMGB1=7.2ng/ml and 6.4ng/ml, respectively yielded similar diagnostic value as infarct transmurality ≥75% for the prediction of residual ejection fraction (ΔAUC=0.03 for STEMI and ΔAUC=0.07 for NSTEMI, p=NS for both).

    Conclusions: HMGB1 expression levels can be easily determined and represent a highly valuable surrogate parameter for infarct transmurality and for the prediction of residual LV-function in patients with acute ischemic syndromes.

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