What is the clinical evidence from this study?

Study design: Case-Control. Population: Heart failure with preserved ejection fraction (HFpEF) (n=276). Intervention: Elevated serum HMGB1 levels vs. Lower serum HMGB1 levels. Primary outcome: All-cause mortality (HR 1.953, 95% CI 1.165-3.275, p=0.011).

What question did this study set out to answer?

To investigate the role of high-mobility group box 1 (HMGB1) in atrial fibrillation occurrence and prognosis among patients with heart failure with preserved ejection fraction (HFpEF).

July 12, 2026Scientific ReportsOpen Access

HMGB1 is associated with atrial fibrillation and prognosis in heart failure with preserved ejection fraction

Q: What does this research mean for the field?

Elevated serum HMGB1 levels are associated with atrial fibrillation and independently predict increased all-cause mortality in patients with heart failure with preserved ejection fraction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Elevated serum HMGB1 is linked to ~95% greater all-cause mortality risk in HFpEF.

HR 1.953
95% CI 1.165-3.275
P=0.011
n=276

Why the study?

The role of HMGB1 in AF occurrence and prognosis among patients with HFpEF was unknown.

Does elevated serum HMGB1 predict atrial fibrillation and all-cause mortality in patients with heart failure with preserved ejection fraction?

Key Points

To investigate the role of high-mobility group box 1 (HMGB1) in atrial fibrillation occurrence and prognosis among patients with heart failure with preserved ejection fraction (HFpEF).
Enrolled 276 patients with HFpEF and measured baseline serum HMGB1 levels.
Followed patients for 360 days to evaluate atrial fibrillation status and all-cause mortality using multivariable logistic regression, Cox proportional hazards regression, and ROC curve analysis.
Serum HMGB1 levels were elevated in HFpEF patients with AF, with significantly higher levels in persistent AF compared to paroxysmal AF (16.26 ± 6.50 vs 13.02 ± 8.04 pg/ml, P = 0.040).
Multivariate Cox regression showed that elevated HMGB1 independently predicted increased all-cause mortality (HR = 1.953, 95% CI: 1.165–3.275, P = 0.011).
ROC analysis for mortality prediction yielded an AUC of 0.897 (95% CI: 0.847–0.948) with an optimal cutoff of 16.75 pg/ml, achieving a sensitivity of 1.000 and specificity of 0.762.

Study Design

Type

Case-Control (n=276)

Multicenter

Structured PICO

Does elevated serum HMGB1 predict atrial fibrillation and all-cause mortality in patients with heart failure with preserved ejection fraction?

Population

276 patients with heart failure with preserved ejection fraction (HFpEF) followed for 360 days to assess the association of HMGB1 with atrial fibrillation and all-cause mortality.

Comparator

HFpEF patients without atrial fibrillation (for AF occurrence analysis)

Outcome

Atrial fibrillation occurrence and all-cause mortality at 360 dayshard clinical

Main Result

Hazard Ratio: 1.953 (95% CI 1.165–3.275)

p-value: p=0.011

Elevated serum HMGB1 levels are associated with the presence of atrial fibrillation and independently predict 1-year all-cause mortality in patients with HFpEF.

Limitations

Small sample size
Cross-medication during follow-up
Unquantified duration of drug administration
Collinearity-induced suppression bias in the AF prediction model
Single-center study with a relatively small sample size and potential selection bias
Only serum HMGB1 levels were examined, without investigating expression in atrial tissues
HMGB1 merely reflects the severity of heart failure rather than directly predicting AF

Discussion

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Implication

Elevated HMGB1 may indicate higher mortality risk; leaves open its value as a prognostic biomarker pending prospective validation.

Cite This Study

Ge et al. (2026) conducted a case-control in Heart failure with preserved ejection fraction (HFpEF) (n=276). Elevated serum HMGB1 levels vs. Lower serum HMGB1 levels was evaluated on All-cause mortality (HR 1.953, 95% CI 1.165-3.275, p=0.011). Elevated serum HMGB1 levels were significantly associated with an increased risk of all-cause mortality (HR 1.953) in patients with heart failure with preserved ejection fraction.

synapsesocial.com/papers/6a532e624f7abc118adecc3a https://doi.org/10.1038/s41598-026-59329-6

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HMGB1 is associated with atrial fibrillation and prognosis in heart failure with preserved ejection fraction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

HMGB1 is associated with atrial fibrillation and prognosis in heart failure with preserved ejection fraction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider