Elevated Circulating HMGB1 Levels as a Potential Biomarker for the Diagnosis and Therapy of Heart Failure: A Cross-Sectional Study.

Background: High-mobility group box 1 (HMGB1), a damage-associated molecular pattern (DAMP), has increasingly been implicated in the pathogenesis of various cardiovascular diseases. This study aimed to elucidate the relationship between circulating HMGB1 levels and the development of heart failure (HF). Methods: This single-center cross-sectional study enrolled 412 patients presenting with chest tightness or pain at the Department of Cardiovascular Medicine, First Affiliated Hospital of Nanchang University, between January and July 2025. The relationship between HMGB1 and HF occurrence was evaluated using Spearman's correlation analysis, logistic regression models, restricted cubic spline (RCS) plots, and receiver operating characteristic (ROC) curves. Subgroup analyses were also performed to assess the robustness of the findings. Results: Of the 412 enrolled patients, 343 were included in the final analysis after application of the exclusion criteria; 151 were diagnosed with HF, and 192 served as controls. Serum HMGB1 levels were significantly higher in the HF group than in the control group (1.53 ng/mL vs 0.93 ng/mL; Conclusions: The levels of HMGB1 elevation were significantly related to the occurrence of HF, which may serve as a potential biomarker for the development of innovative therapeutic strategies in patients with heart failure.