Value of serum HMGB1 and sRAGE levels in predicting the prognosis of patients with acute decompensated heart failure
Objective:To investigate the value of serum high mobility group protein box1(HMGB1)and soluble recep-tor of advanced glycation end product(sRAGE)levels in the prognostic evaluation of acute decompensated heart failure(ADHF).Methods:Totally,190 ADHF patients were regarded as the research group.In addition,191 healthy people who were examined in our hospital were served as the control group.All ADHF patients were divided into a poor prognosis group(58 cases)and a good prognosis group(132 cases)according to whether they died during the 1-year follow-up period.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of serum HMGB1 and sRAGE.The cardiac function indexes and laboratory indexes of the patients in this group were collected.The Pearson method was used to analyze the correlation between serum HMGB1 and sRAGE levels and cardiac function indexes and laboratory indexes in ADHF patients.The ROC curve was used to analyze the predictive value of HMGB1 and sRAGE in assessing the poor prog-nosis of ADHF patients.The multivariate Logistic regression was used to analyze the related factors affecting the poor progno-sis of ADHF patients.Results:As compared with the control group,the levels of serum HMGB1 and sRAGE in the study group were obviously increased(P＜0.05).As compared with the good prognosis group,the levels of serum HMGB1 and sRAGE in the poor prognosis group were obviously increased(P＜0.05).There were obvious differences in NYHA classifi-cation,LVESD,LVEDD,LVEF,NT-proBNP,cTnl,and length of hospital stay of ADHF patients between the good progno-sis group and the poor prognosis group(P＜0.05).The Pearson analysis showed that serum HMGB1 and sRAGE in ADHF patients were positively correlated with LVEDD,LVESD,NT-proBNP,and cTnl,respectively,and negatively correlated with LVEF(P＜0.05),and serum HMGB1 and sRAGE in ADHF patients were positively correlated(P＜0.05).The Pearson's analysis revealed that serum HMGB1 and sRAGE in ADHF patients were positively correlated with LVEDD,LVESD,NT-proBNP and cTnl,and negatively correlated with LVEF(P＜0.05).Serum HMCB1 was positively correlated with sRACE(P＜0.05).The ROC curve analysis showed that the AUC of HMGB1,sRAGE and NT-proBNP for poor prog-nosis in ADHF patients was 0.869(0.814-0.924),0.852(0.794-0.911)and 0.844(0.778-0.911),respectively,and the best diagnostic cut-off value was 32.91 g/L,296.46 ng/L and 3809.77 ng/L,respectively,with the corresponding sen-sitivity being 79.3％,82.8％and 82.8％,respectively,and the specificity being 83.3％,74.2％and 79.5％,respec-tively.Multivariate logistic regression analysis showed that the cardiac function class,LVEF,NT-proBNP,HMGB1 and sRAGE were independent risk factors for prognosis in ADHF patients(P＜0.05).Conclusion:The expression of HMGB1 and sRAGE is related to the occurrence and prognosis of ADHF,and can be used as an auxiliary indicator of the prognosis of ADHF patients.
Acute decompensated heart failureHigh mobility group protein box1Soluble receptor of advanced glyca-tion end productPrognosis
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