Abstract
Short leukocyte telomere length (LTL) has been associated with atherosclerosis in cross-sectional studies, but the prospective relationship between telomere shortening and risk of developing carotid atherosclerosis has not been well-established. This study examines whether LTL at baseline predicts incidence and progression of carotid atherosclerosis in American Indians in the Strong Heart Study. The analysis included 2,819 participants who were free of overt cardiovascular disease at baseline (2001-2003) and were followed through the end of 2006-2009 (average 5.5-yr follow-up). Discrete atherosclerotic plaque was defined as focal protrusion with an arterial wall thickness ≥50% the surrounding wall. Carotid progression was defined as having a higher plaque score at the end of study follow-up compared to baseline. Associations of LTL with incidence and progression of carotid plaque were examined using Cox proportional hazard regression, adjusting for standard coronary risk factors. Compared to participants in the highest LTL tertile, those in the lowest tertile had significantly elevated risk for both incident plaque (HR, 1.49; 95% CI, 1.09-2.03) and plaque progression (HR, 1.61; 95% CI, 1.26-2.07). Our results provide initial evidence for a potential prognostic utility of LTL in risk prediction for atherosclerosis.
Highlights
Telomeres are special chromatin structures and associated proteins at the end of each chromosome that protect chromosomes from degradation and recombination
The current study seeks to investigate whether leukocyte telomere length (LTL) could be a potential prognostic factor predicting progression of carotid atherosclerosis in a prospectively examined population of American Indians participating in the Strong Heart Family Study (SHFS)
Well-characterized prospective cohort of American Indians, we found that LTL significantly predicts incidence and progression of carotid atherosclerosis, independent of established cardiovascular risk factors including diabetes and hypertension
Summary
Telomeres are special chromatin structures and associated proteins at the end of each chromosome that protect chromosomes from degradation and recombination. They are formed by tandem repeats made up of TTAGGG sequence in vertebrates[1]. Among the very few longitudinal studies, shortened LTL was associated with all-cause mortality in patients with stable coronary artery disease [14] or type 1 diabetes [15], but no study has examined the potential role of telomere shortening in development and progression of carotid atherosclerosis in a large, community-based cohort. The current study seeks to investigate whether LTL could be a potential prognostic factor predicting progression of carotid atherosclerosis in a prospectively examined population of American Indians participating in the Strong Heart Family Study (SHFS)
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