Elevated Serum HMGB1 Levels and Their Association with Recurrence of Acute Ischaemic Stroke

Purpose:The study aimed to investigate the correlation between baseline serum levels of high mobility group box 1 (HMGB1) and the recurrence of acute ischemic stroke (AIS).Patients and Methods: A total of 544 AIS patients were enrolled and followed up monthly.Serum HMGB1 levels were measured using enzyme-linked immunosorbent assay (ELISA).The primary endpoint was the first recurrence of AIS.Results: During a median follow-up period of 43 months, 62 of the 544 AIS patients experienced a recurrence.Both HMGB1 levels and national institute of health stroke scale (NIHSS) scores were significantly higher in the recurrence group compared to the norecurrence group (p<0.05).According to the receiver operating characteristic curve analysis, the combination (0.855, 95% CI: 0.800-0.911) of HMGB1 (0.745, 95% CI: 0.663-0.826)and NIHSS (0.822, 95% CI: 0.758-0.886)had a higher value for predicting AIS recurrence than either of them (p<0.05).Kaplan-Meier analyses demonstrated that the cumulative survival without AIS recurrence was significantly lower in patients in the high HMGB1 level group than in the low HMGB1 level group (p<0.05).The multifactorial Cox analyses indicated that elevated baseline serum HMGB1 levels (HR: 7.489, 95% CI:4.383-12.795)were a highly effective predictor of recurrence in AIS.Conclusion: Elevated baseline serum HMGB1 levels were found to be a highly effective predictor of recurrence in AIS.