Abstract 5904: Telomere Length and Outcome in Heart Failure
Background: Telomeres are causally involved in senescence. Senescence is a potential factor in the pathogenesis and progression of heart failure. In heart failure telomeres are shorter, but the prognostic value associated with telomere length has not been defined.
Methods and Results: Telomere length was prospectively determined by quantitative polymerase chain reaction in 890 patients with New York Heart Association (NYHA) functional class II to IV heart failure. After 18 months, we examined the association between telomere length and the predefined primary endpoint; time to death or hospitalization for heart failure. A total of 344 patients reached the primary endpoint (130 deaths and 214 hospitalizations). Patients with shorter telomeres were at an increased risk of reaching the primary endpoint (hazard ratio 1.79; 95 percent confidence interval, 1.21 to 2.63). In multivariate analysis shorter telomere length remained associated with a higher risk for death or hospitalization (hazard ratio, 1.70; 95 percent confidence interval, 1.05 to 2.75) after adjustment for age, age of heart failure onset, gender, hemoglobin, renal function, use of renin-angiotensin system inhibitors, and N-terminal pro-B-type natriuretic peptide level.
Conclusions: Shorter length of telomeres predicts the occurrence of death or hospitalization in patients with chronic heart failure.