Abstract 14881: Shortened Telomere Length is Associated with Paroxysmal but Not Persistent/Permanent Atrial Fibrillation in Cardiovascular Patients Referred for Angiography

Abstract

BACKGROUND: Telomeres are hexanucleotide repeats at chromosome ends that prevent chromosome degradation. Short telomere length (TL) correlates with biological ageing and is associated with risk for age-associated diseases. Atrial fibrillation (AF) can occur as paroxysmal (Px), persistent (Ps) or permanent (Pm). Progression from Px to Ps/Pm AF is accompanied by increased risk for AF-associated adverse events. We t found that short TL is associated with a history of AF; for the present study we examined TL in relationship to the types of AF. METHODS: Peripheral blood DNA was obtained from sequential consenting patients (pts) (n=3576) at angiography. TL was measured in triplicate by monochrome (SYBR Green I) multiplex quantitative PCR (Bio-Rad CFX384 Detection System) and normalized to a quantitatively-measured, single-copy gene (albumin). AF history was extracted from Intermountain Healthcare’s electronic records and AF type determined by chart review for 246 of 325 (75.7%) AF patients. Non-parametric tests were used. RESULTS: For the 246 subtyped AF pts, 66.3% were male, 94.3% Caucasian, mean age was 70 yrs. The leading AF type was Px (43.5%), followed by Pm (32.9%), and Ps (23.6%). Mean TL for non-AF pts was 0.954 ±0.325 and the mean TL for AF pts was 0.912±0.30. The mean Px TL (Table) was significantly shorter than for Ps or Pm AF. Ps and Pm TL did not differ. Adjusting for age, gender, prior CVA, PCI, statin use, disease severity; TL (per unit of decrease) was associated with Px AF compared to Ps/Pm AF (OR=6.64; CI 2.17, 20.32; p=0.0009). CONCLUSIONS: The association of shorter TL with Px AF but not Ps/Pm AF suggests that decreased TLs is associated with an etiologic AF subtype. No association between shortened TL and Ps/Pm AF may further suggest that TL measurement for pts with Px AF may have prognostic utility with respect to AF progression. Further study into the physiological basis of these observations is warranted.