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Romaine et al. (2021) - BIOSTAT Telomere Paper (Author Accepted Manuscript).pdf (503.48 kB)

Telomere length is independently associated with all-cause mortality in chronic heart failure

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posted on 2021-05-27, 11:32 authored by Simon PR Romaine, Matthew Denniff, Veryan Codd, Mintu Nath, Andrea Koekemoer, Stefan D Anker, John G Cleland, Gerasimos Filippatos, Daniel Levin, Marco Metra, Ify R Mordi, Wouter Ouwerkerk, Jozine M Ter Maaten, Dirk J van Veldhuisen, Faiez Zannad, Leong L Ng, Pim van der Harst, Chim C Lang, Adriaan A Voors, Christopher P Nelson, Nilesh J Samani

Objective

Patients with heart failure have shorter mean leucocyte telomere length (LTL), a marker of biological age, compared with healthy subjects, but it is unclear whether this is of prognostic significance. We therefore sought to determine whether LTL is associated with outcomes in patients with heart failure.

Methods

We measured LTL in patients with heart failure from the BIOSTAT-CHF Index (n=2260) and BIOSTAT-CHF Tayside (n=1413) cohorts. Cox proportional hazards analyses were performed individually in each cohort and the estimates combined using meta-analysis. Our co-primary endpoints were all-cause mortality and heart failure hospitalisation.

Results

In age-adjusted and sex-adjusted analyses, shorter LTL was associated with higher all-cause mortality in both cohorts individually and when combined (meta-analysis HR (per SD decrease in LTL)=1.16 (95% CI 1.08 to 1.24); p=2.66×10-5), an effect equivalent to that of being four years older. The association remained significant after adjustment for the BIOSTAT-CHF clinical risk score to account for known prognostic factors (HR=1.12 (95% CI 1.05 to 1.20); p=1.04×10-3). Shorter LTL was associated with both cardiovascular (HR=1.09 (95% CI 1.00 to 1.19); p=0.047) and non-cardiovascular deaths (HR=1.18 (95% CI 1.05 to 1.32); p=4.80×10-3). There was no association between LTL and heart failure hospitalisation (HR=0.99 (95% CI 0.92 to 1.07); p=0.855).

Conclusion

In patients with heart failure, shorter mean LTL is independently associated with all-cause mortality.

History

Author affiliation

Department of Cardiovascular Sciences

Version

  • AM (Accepted Manuscript)

Published in

Heart

Publisher

BMJ Publishing Group

issn

1355-6037

eissn

1468-201X

Acceptance date

2021-03-01

Copyright date

2021

Available date

2021-05-27

Spatial coverage

England

Language

eng

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