In ischemic states, the effect of cardiotoxic drugs, hyperglycemia, infection, autoimmune response or mechanical stress causes oxidative stress and nitrosative stress which then causes tissue necrosis with the resultant passive release of HMGB1 or increased secretion of HMGB1 acetate from the heart actively and stimulation of inflammatory cells [73]. The gene discussed is HMGB1; the disease is Hyperglycemia.