The Effect of Eplerenone on Circulating Microparticle Numbers in Patients with Chronic Heart Failure

The study aim was to evaluate whether the Mineralocorticoid Receptors (MR) antagonist eplerenone, effects circulating microparticles originated from apoptotic and activated endothelial cells (EMP) in Chronic Heart Failure (CHF) patients. Methods: The study population consisted of 152 consecutive patients with CHF who underwent angiography or PCI between April 2010 and June 2014, and post-myocardial infarction subjects. All subjects enrolled in the study were divided into two cohorts: eplerenone treated (n=45) or placebo (n=107) for 52 weeks. Patients were treated with optimal dose of eplerenone (25-50 mg daily) adjusted to plasma potassium. All biomarkers were determined at the beginning (baseline) and at the termination of the study. Endothelialderived Microparticles (EMPs) were phenotyped by flow cytometry using a High-Definition Fluorescence Activated Cell Sorter. Results: At baseline, there was not difference in EMPs between groups. Eplerenone treatment reduced EMPs (CD144+/ CD31+/annexin V+ and CD31+/annexin V+) when compared with placebo. But activated CD62E+ EMP numbers were significantly increased by 24.3%. Conclusion: Eplerenone reduces circulating EMPs in CHF patients, suggesting reduced endothelial damage. Circulating EMPs could provide a novel marker for organ damage in CHF patients