Mikel Allende1, Eva Molina1, José Ramón González-Porras1, Estefanía Toledo1, Ramón Lecumberri1, José Hermida2. 1. From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.). 2. From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.). jhermida@unav.es.
Abstract
BACKGROUND AND PURPOSE: The risk of cardioembolic stroke in patients with atrial fibrillation (AF) cannot be accurately assessed and novel tools are needed to improve prediction. We hypothesize that telomere shortening constitutes a novel risk factor for cardioembolic stroke in patients with AF. METHODS: The peripheral blood leukocyte telomere length (LTL) was determined by real-time polymerase chain reaction in 187 patients with AF, 93 of them without stroke history and 94 of them having suffered 1 cardioembolic stroke. Percentiles were calculated according to LTL values in the nonstroke group to estimate the cardioembolic stroke risk associated with LTL using logistic regression models. RESULTS: Short LTL values were independently and dose-dependently associated with an increased risk of cardioembolic stroke, with an odds ratio (95% confidence interval) of 2.93 (1.24-6.94) and 6.26 (2.01-19.52), respectively, for sex, hypertension, diabetes mellitus, heart failure, and age-adjusted models using the LTL 10th and 5th percentile cut-offs, respectively. CONCLUSIONS: Telomere shortening is associated with cardioembolic stroke risk in patients with AF. Prospective studies are encouraged to establish the value of LTL to improve prediction tools to categorize cardioembolic stroke risk in AF.
BACKGROUND AND PURPOSE: The risk of cardioembolic stroke in patients with atrial fibrillation (AF) cannot be accurately assessed and novel tools are needed to improve prediction. We hypothesize that telomere shortening constitutes a novel risk factor for cardioembolic stroke in patients with AF. METHODS: The peripheral blood leukocyte telomere length (LTL) was determined by real-time polymerase chain reaction in 187 patients with AF, 93 of them without stroke history and 94 of them having suffered 1 cardioembolic stroke. Percentiles were calculated according to LTL values in the nonstroke group to estimate the cardioembolic stroke risk associated with LTL using logistic regression models. RESULTS: Short LTL values were independently and dose-dependently associated with an increased risk of cardioembolic stroke, with an odds ratio (95% confidence interval) of 2.93 (1.24-6.94) and 6.26 (2.01-19.52), respectively, for sex, hypertension, diabetes mellitus, heart failure, and age-adjusted models using the LTL 10th and 5th percentile cut-offs, respectively. CONCLUSIONS: Telomere shortening is associated with cardioembolic stroke risk in patients with AF. Prospective studies are encouraged to establish the value of LTL to improve prediction tools to categorize cardioembolic stroke risk in AF.
Authors: Katarzyna Polonis; Virend K Somers; Christiane Becari; Naima Covassin; Phillip J Schulte; Brooke R Druliner; Ruth A Johnson; Krzysztof Narkiewicz; Lisa A Boardman; Prachi Singh Journal: Am J Physiol Heart Circ Physiol Date: 2017-08-19 Impact factor: 4.733
Authors: Laila Staerk; Biqi Wang; Kathryn L Lunetta; Robert H Helm; Darae Ko; Jason A Sherer; Patrick T Ellinor; Steven A Lubitz; David D McManus; Ramachandran S Vasan; Emelia J Benjamin; Ludovic Trinquart Journal: J Am Heart Assoc Date: 2017-11-14 Impact factor: 5.501