title: Circulating endothelial-derived apoptotic microparticles in the patients with ischemic symptomatic chronic heart failure: relevance of pro-inflammatory activation and outcomes.
abstract: BACKGROUND
  Endothelial-derived apoptotic microparticles (EMPs) play a pivotal role in endothelial dysfunction in hronic Heart Failure (CHF).
  
  
  OBJECTIVE
  The present study aimed to evaluate the association between EMPs and pro-inflammatory biomarkers, clinical status, and outcomes in the patients with ischemic CHF.
  
  
  METHODS
  This study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF on discharge from hospital. The observation period was up to 3 years. Circulating NT-pro-BNP, TNF-alpha, sFas, and sFas ligand were determined at baseline. Flow cytometry analysis was used for quantifying the number of EMPs. All-cause mortality, CHF-related death, and CHD-re-hospitalization rate were examined. The data were analyzed using descriptive statistics, Receive Operation Characteristic Curve (ROC), and logistic regression analysis. Besides, P < 0.05 was considered as statistically significant.
  
  
  RESULTS
  During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. The results showed a significant difference between the patients with a large number of EMPs (> 0.514 n/mL) and those with a low level of the biomarker (< 0.514 n/mL) regarding their survival. The number of circulating EPMs independently predicted all-cause mortality (OR = 1.58; 95% CI = 1.20 - 1.88; P = 0.001), CHF-related death (OR = 1.22; 95% CI: 1.12 - 1.36; P < 0.001), and CHF-related re-hospitalization (OR = 1.20; 95% CI: 1.11 - 1.32; P < 0.001).
  
  
  CONCLUSIONS
  Among the patients with symptoms of CHF, increased number of circulating EMPs was associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF.
authors.affiliation: State Medical University, Internal Medicine Department, Zaporozhye, Ukraine.
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Berezin
authors.affiliation: State Medical University, Clinical Pharmacology Department, Zaporozhye, Ukraine.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Kremzer
authors.affiliation: State Medical University, Clinical Pharmacology Department, Zaporozhye, Ukraine.
authors.forename: Tatayna A
authors.initials: TA
authors.lastname: Samura
authors.affiliation: State Medical University, Pathology Department, Zaporozhye, Ukraine.
authors.forename: Yulia V
authors.initials: YV
authors.lastname: Martovitskaya
keywords: Heart Failure; Inflammation; Microparticles; Prognosis; Survival