Predictive Value of Circulating Apoptotic Microparticles in Patients with Ischemic Symptomatic Moderate-To-Severe Chronic Heart FailureAlexander E Berezin1*, Alexander A Kremzer2, Tatayna A Samura2 and Yulia V Martovitskaya3
- *Corresponding Author:
- Alexander E Berezin
Professor, Chief of Cardiology unit, Internal medicine Department
State Medical University, # 28 Chuykov Str.
Apt. 137, Box 6323, Zaporozhye, PO: 69121, Ukraine
Tel: +38 061 2729607
Fax: +38 061 2729607
E-mail: [email protected]
Received Date: January 02, 2014; Accepted Date: January 25, 2014; Published Date: February 03, 2014
Citation: Berezin AE, Kremzer A A, Samura TA, Martovitskaya YV (2014) Predictive Value of Circulating Apoptotic Microparticles in Patients with Ischemic Symptomatic Moderate-To-Severe Chronic Heart Failure. Angiol 2:121. doi: 10.4172/2329-9495.1000121
Copyright: © 2014 Berezin AE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aim: To evaluate the prognostic value of circulating CD31+/annexin V+ Microparticles (MPs) for cumulative survival in patients with ischemic Chronic Heart Failure (CHF).
Methods: A total of 154 patients with ischemic symptomatic moderate-to-severe CHF were enrolled in the study on discharge from the hospital. Observation period was up to 3 years. Blood samples for biomarkers measurements were collected. Flow cytometry analysis for quantifying the number of CD31+/annexin V+ MPs was used. CD31+/ annexin V+ MPs number for cumulative survival cases due to CHF were tested. Additionally, all-cause mortality, and CHF-related death were examined.
Results: During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. Medians of circulating levels of CD31+/annexin V+ MPs in patients who survived and subjects who died were 0.286 n/mL (95% confidence interval [CI] = 0.271-0.309 n/mL) and 0.673 n/mL (95% CI = 0.65-0.74 n/ mL) (P<0.001). Number of circulating MPs was distributed into Quartiles (Q): Q1 (< 0.341 n/mL), Q2 (0.342-0.514 n/mL), Q3 (0.521-0.848 n/mL), and Q4 (> 0.850 n/mL). ROC analysis has been shown that cut off point of CD31+/ annexin V+ MPs number for cumulative survival function was 0.514 n/mL. Area under cure was 0.913 (Std. error = 0.025; 95% CI = 0.863-0.962), sensitivity and specificity were 89.6% and 69.7% respectively. It has been found a significantly divergence of Kaplan-Meier survival curves in patients with high quartile (MPs number >0.514 n/mL) of MPs numbers when compared with low quartiles. Using a stepwise model selection method for multivariable prediction model we investigated that CD31+/annexin V+ MPs number alone and combination of CD31+/annexin V+ MPs number with NT-pro-brain natriuretic peptide (NT-pro-BNP) remained statistically significant predictors for all-cause mortality, CHF-related death, and CHF-related re-hospitalisations, whereas combination of CD31+/annexin V+ MPs with both NT-pro-BNP and left ventricular ejection fraction did not.
Conclusion: Increased circulating CD31+/annexin V+ MPs associates with increased 3-year CHF-related death, all-cause mortality, and risk for recurrent hospitalization due to CHF.