Change in Leukocyte Telomere Length Predicts Mortality in Patients with Stable Coronary Heart Disease from the Heart and Soul Study.

Autor: Goglin SE; Department of Medicine, University of California San Francisco, San Francisco, CA, 94143, United States of America., Farzaneh-Far R; Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94143, United States of America., Epel ES; Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94143, United States of America., Lin J; Department of Biochemistry and Biophysics, UCSF, San Francisco, CA, 94143, United States of America., Blackburn EH; Veterans Affairs Medical Center, San Francisco, CA, 94121, United States of America., Whooley MA; Department of Medicine, University of California San Francisco, San Francisco, CA, 94143, United States of America.; Veterans Affairs Medical Center, San Francisco, CA, 94121, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Oct 26; Vol. 11 (10), pp. e0160748. Date of Electronic Publication: 2016 Oct 26 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0160748
Abstrakt: Background: Short telomere length independently predicts mortality in patients with coronary heart disease. Whether 5-year change in telomere length predicts subsequent mortality in patients with coronary heart disease has not been evaluated.
Methods: In a prospective cohort study of 608 individuals with stable coronary artery disease, we measured leukocyte telomere length at baseline and after five years of follow-up. We divided the sample into tertiles of telomere change: shortened, maintained or lengthened. We used Cox survival models to evaluate 5-year change in telomere length as a predictor of mortality.
Results: During an average of 4.2 years follow-up, there were 149 deaths. Change in telomere length was inversely predictive of all-cause mortality. Using the continuous variable of telomere length change, each standard deviation (325 base pair) greater increase in telomere length was associated with a 24% reduction in mortality (HR 0.76, 95% CI 0.61-0.94; p = 0.01), adjusted for age, sex, waist to hip ratio, exercise capacity, LV ejection fraction, serum creatinine, and year 5 telomere length. Mortality occurred in 39% (79/203) of patients who experienced telomere shortening, 22% (45/203) of patients whose telomere length was maintained, and 12% (25/202) of patients who experienced telomere lengthening (p<0.001). As compared with patients whose telomere length was maintained, those who experienced telomere lengthening were 56% less likely to die (HR 0.44, 95% CI, 0.23-0.87).
Conclusions: In patients with coronary heart disease, an increase in leukocyte telomere length over 5 years is associated with decreased mortality.
Competing Interests: We have read the journal’s policy and acknowledge that authors of this manuscript have the following competing interests: Drs. Epel, Lin and Blackburn were co-founders of Telome Health (now Telomere Diagnostics). Dr. Lin currently serves as a scientific advisor to Telomere Diagnostics, but Drs. Blackburn and Epel are no longer affiliated with the company and hold no equity or financial interest in it.
Databáze: MEDLINE
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