Apoptotic Microparticles as Predicted Biomarkers in Patients with Chronic Heart Failure – Relevance to Inflammatory Cytokines and Outcomes

Aim: To evaluate the relevance of endothelial-derived apoptotic microparticles (EMPs) with inflammatory cytokine outcomes in patients with ischaemic chronic heart failure (CHF). Methods: A total of 154 patients with moderate-to-severe CHF were enrolled in the study. Flow cytometry analysis was used for quantifying the number of EMPs. All-cause mortality, CHF-related death, and CHD-readmission rates were examined. Results: During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. Medians of circulating EMPs in survivor and non-survivor patient cohorts were 0.286 n/mL (95% CI = 0.271-0.309 n/mL) and 0.673 n/mL (95% CI = 0.65-0.74 n/mL) (P<0.001). There was a significantly lower concentration of sRANKL, OPG, TNF-alpha, sFAS, and sFAS ligand in the survivor patients when compared with those who met composed endpoints. The sFAS/sFAS ligand ratio in the non-survivor patient cohort was significantly higher than in the survivor cohort (P<0.001). In multivariate model EPMs, NYHA class, NT-pro-BNP, TNF-alpha, sFAS/sFAS ligand ratio, and OPG remained statistically significant for the cumulative endpoint: all-cause mortality, CHF-related death, and CHF-related readmission. Conclusion: Increased apoptotic circulating EMPs, OPG, and FAS-sFAS ligand ratio independently predicted cumulative survival in CHF patients.