Prognostic Value Of High Mobility Group Protein B1 For Patients With Acute Coronary Syndrome

Objective:High mobility group protein B1 is a kind of highly conserved non histone proteins which widely exists in eukaryotic nucleus.Recent studies show that high mobility group protein B1 plays an important role not only in immune inflammatory reaction,but also in myocardial ischemia reperfusion injury,which can directly affect the prognosis of patients with coronary heart disease.The prognostic value of high mobility group box1 in China population is not well established.Lipoprotein associated phospholipase A2,as a member of the phospholipase superfamily,is confirmed to be a specific vascular marker,not only taks part in the development of coronary atherosclerosis,but find that it can help the risk assessment of patients with acute coronary syndrome.The global registry of acute coronary events（GRACE）risk scoring system is widely used in ACS patients,which can effectively predict the prognosis of patients with ACS.Our aim was to explore the characteristics and prognostic value of high mobility group protein B1 and lipoprotein associated phospholipase A2 in hospitalized Chinese acute coronary syndrome patients undergoing selective percutaneous coronary intervention and analyse the correlation of high mobility group protein B1 with GRACE score and other laboratory index.Methods:Between January 2014 and March 2015,we consecutively enrolled 380patients who were first diagnosed as acute coronary syndrome,according to current Chinese guidelines.Adverse events were defined as all-cause death and readmission due to coronary heart disease.Demographic data from medical records are abstracted.The plasma concentrations of high mobility group box1 and lipoprotein associated phospholipase A₂ were measured by enzyme 1inked immunosorbent assay.The plasma was collected from patients arterial blood samples before coronary angiography.Multivariable Cox proportional hazards analysis were used to assess the association of high mobility group box1 and lipoprotein associated phospholipase A₂ with adverse events.Receiver operating characteristic（ROC）were performed to determine the prognostic ability of novel biomarker for events.Results:During a median follow-up of 2 years,a total of 380 patients undergoing elective percutaneous coronary intervention were included,among which 99patients experienced adverse events.Univariable and multivariable Cox regression analyses showed high mobility group box1 concentrations、lipoprotein associated phospholipase A₂ and GRACE score were significantly associated with survival outcome（P<0.05）.In ROC analysis,the area under the curve was 0.851（95%CI 0.811⁰.891,P<0.05）.Conclusions:High mobility group box 1 and lipoprotein associated phospholipase A₂are strong independent risk predictors for Patients with Acute Coronary Syndrome Undergoing Selective Percutaneous Coronary Intervention and have a good correlation with GRACE score.The combination of GRACE score with high mobility group box protein B1 and lipoprotein associated phospholipase A₂ can improve the prediction of clinical prognosis.