Abstract 19518: The Association of Telomere Length and Major Adverse Cardiac Events Among Patients With Obstructive Sleep Apnea
Background: Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular diseases (CVD). Telomere length (TL) has emerged as a novel potential predictor of CVD. However, the prognostic value of TL in OSA has not been investigated.
Hypothesis: TL is associated with Major Adverse Cardiac Events (MACE) in OSA.
Methods: Genomic DNA was isolated from circulating leukocytes in 181 subjects without prior history of MACE. TL was measured using quantitative PCR. All subjects underwent polysomnography. OSA status was classified as non-OSA (control) group [Apnea Hypopnea Index (AHI) <5 events/h, n=103)], mild OSA (5 ≤ AHI <15, n=21) and to moderate-to-severe OSA (AHI ≥15, n=57). Unadjusted Cox proportional hazards models individually examined the association of TL and OSA status on subsequent MACEs. The TL and MACEs association was similarly evaluated in the subset of OSA subjects.
Results: Compared to subjects without OSA, OSA subjects were older (control: mean±SD = 36±11, mild OSA: 45±10, moderate-to-severe OSA: 49±13 years). There was no age difference between the two OSA groups. The association of OSA severity with TL showed a U-shaped curve: longer TL in moderate-to-severe OSA (4909 ± 231 bp) and non-OSA (4851 ± 212 bp), and the shortest TL in mild OSA (4734 ± 145 bp). During an average 11 ± 3 year follow-up, 29 cases of MACEs were recorded. Compared to non-OSA, the moderate-to-severe OSA was associated with an increased risk of MACEs [HR 2.8 (95% CI 1.2 - 6.7), p=0.02] while mild OSA was associated with a non-statistically significant increased risk [HR 2.7 (0.8 - 8.2), p=0.09]. TL was not associated with risk of MACE in the overall cohort, nor in the subset of OSA subjects.
Conclusion: Moderate-to-severe OSA had the highest risk of MACE. Telomere length was not associated with risk of MACE overall or in the subset of OSA subjects. Nevertheless, observed changes in TL across OSA groups may help in understanding pathophysiological processes underlying cardiovascular risk in OSA patients.
Author Disclosures: K. Polonis: None. V.K. Somers: None. C. Becari: None. J. Xie: None. P. Schulte: None. N. Covassin: None. B. Druliner: None. R. Johnson: None. K. Narkiewicz: None. L. Boardman: None. P. Singh: None.
- © 2016 by American Heart Association, Inc.