Leukocyte telomere length and left ventricular function after acute ST-elevation myocardial infarction: data from the glycometabolic intervention as adjunct to primary coronary intervention in ST elevation myocardial infarction (GIPS-III) trial

Clin Res Cardiol. 2015 Oct;104(10):812-21. doi: 10.1007/s00392-015-0848-x. Epub 2015 Apr 4.

Abstract

Background: Telomere length has been associated with coronary artery disease and heart failure. We studied whether leukocyte telomere length is associated with left ventricular ejection fraction (LVEF) after ST-elevation myocardial infarction (STEMI).

Methods and results: Leukocyte telomere length (LTL) was determined using the monochrome multiplex quantitative PCR method in 353 patients participating in the glycometabolic intervention as adjunct to primary percutaneous coronary intervention in STEMI III trial. LVEF was assessed by magnetic resonance imaging. The mean age of patients was 58.9 ± 11.6 years, 75 % were male. In age- and gender-adjusted models, LTL at baseline was significantly associated with age (beta ± standard error; -0.33 ± 0.01; P < 0.01), gender (0.15 ± 0.03; P < 0.01), TIMI flow pre-PCI (0.05 ± 0.03; P < 0.01), TIMI flow post-PCI (0.03 ± 0.04; P < 0.01), myocardial blush grade (-0.05 ± 0.07; P < 0.01), serum glucose levels (-0.11 ± 0.01; P = 0.03), and total leukocyte count (-0.11 ± 0.01; P = 0.04). At 4 months after STEMI, LVEF was well preserved (54.1 ± 8.4 %) and was not associated with baseline LTL (P = 0.95). Baseline LTL was associated with n-terminal pro-brain natriuretic peptide (NT-proBNP) at 4 months (-0.14 ± 0.01; P = 0.02), albeit not independent for age and gender.

Conclusion: Our study does not support a role for LTL as a causal factor related to left ventricular ejection fraction after STEMI.

Keywords: Left ventricular ejection fraction; Metformin; ST-elevation myocardial infarction; Telomeres.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Causality
  • Combined Modality Therapy
  • Comorbidity
  • Double-Blind Method
  • Female
  • Genetic Predisposition to Disease / epidemiology
  • Genetic Predisposition to Disease / genetics
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Incidence
  • Leukocytes
  • Longitudinal Studies
  • Male
  • Metformin / therapeutic use
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / therapy
  • Netherlands / epidemiology
  • Percutaneous Coronary Intervention / statistics & numerical data
  • Placebo Effect
  • Risk Assessment
  • Telomere Shortening / genetics*
  • Treatment Outcome
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / genetics*
  • Ventricular Dysfunction, Left / therapy

Substances

  • Hypoglycemic Agents
  • Metformin