the association of subclinical hypothyroidism and pattern of circulating endothelial-derived microparticles among chronic heart failure patients

conclusions we believe that the sh state in chf patients may be associated with the impaired pattern of circulating emps, with the predominantly increased number of apoptotic-derived microparticles. background subclinical hypothyroidism (sh) is diagnosed biochemically by the presence of normal serum free thyroxine concentration, in conjunction with an elevated serum thyroid-stimulating hormone level. recent studies have demonstrated the frequent association between sh and cardiovascular diseases and risk factors. objectives to evaluate the impact of sh on patterns of circulating endothelial-derived microparticles, (emps) among chronic heart failure (chf) patients patients and methods this is a retrospective study involving a cohort of 388 patients with chf. fifty-three chf subjects had sh and 335 patients were free from thyroid dysfunction. circulating levels of n-terminal-pro brain natriuretic peptide (nt-probnp), high-sensitivity c-reactive protein (hs-crp), thyroid-stimulating hormone (tsh), total and free thyroxine (t4), and triiodothyronine (t3), and endothelial apoptotic microparticles (emps), were measured at baseline. sh was defined, according to contemporary clinical guidelines, as a biochemical state associated with an elevated serum tsh level of greater 10 μu/l and normal basal free t3 and t4 concentrations. results circulating cd31+/annexin v+ emps were higher in patients with sh compared to those without sh. in contrast, activated cd62e+ emp numbers were not significantly different between both patient cohorts. using uni (bi) variate and multivariate age- and gender-adjusted regression analysis, we found several predictors that affected the increase of the cd31+/annexin v+ to cd62e+ ratio in the patient study population. the independent impact of tsh per 6.5 μu/l (odds ratio [or] = 1.23, p = 0.001), sh (or = 1.22, p = 0.001), nt-probnp (or = 1.19, p = 0.001), nyha class (or = 1.09, p = 0.001), hs-crp per 4.50 mg/l (or = 1.05, p = 0.001), dyslipidemia (or = 1.06, p = 0.001), serum uric acid per 9.5 mmol/l (or = 1.04, p = 0.022) on the increase in the cd31+/annexin v+ to cd62e+ ratio, was determined.