Sun Jin-Yu, Xu Qian, Shen Hui, Huang Wen, Qu Qiang, Sun Wei, Kong Xiang-Qing
Department of Cardiology, Gusu School, Nanjing Medical University, 215008 Suzhou, Jiangsu, China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 210000 Nanjing, Jiangsu, China.
Rev Cardiovasc Med. 2024 Sep 19;25(9):333. doi: 10.31083/j.rcm2509333. eCollection 2024 Sep.
We explore the association between leucocyte telomere length (LTL) and all-cause and cardiovascular disease (CVD)-specific death in CVD patients.
We acquired 1599 CVD patients from a nationally representative US population survey for this study. We applied Kaplan-Meier curves, adjusted weighted Cox regression models, and restricted cubic spline to investigate the association between LTL and all-cause death. Additionally, we employed competing risk regression to assess the impact of LTL on cardiovascular-specific death, setting non-cardiovascular death as a competing event.
The overall mortality rate was 31.0% after a median follow-up of 13.9 years. Patients with shorter LTL exhibited a higher risk of all-cause death, with an adjusted hazard ratio (HR) of 1.25 (95% confidence interval (CI): 1.05-1.48). Restricted cubic spline illustrated a linear dose-response relationship. In gender-specific analyses, female patients with shorter LTL showed a higher risk of death (weighted HR, 1.79; 95% CI, 1.29-2.48), whereas this association was not observed in males (weighted HR, 0.90; 95% CI, 0.61-1.32). The Fine-Gray competing risk model revealed no significant relationship between LTL and cardiovascular-specific mortality but a significant association with non-cardiovascular death (adjusted HR, 1.24; 95% CI, 1.02-1.51).
LTL is inversely associated with all-cause death in female CVD patients. The significant correlation between reduced LTL and increased all-cause mortality emphasizes LTL as a potential marker for tertiary prevention against cardiovascular disease.
我们探讨了白细胞端粒长度（LTL）与心血管疾病（CVD）患者全因死亡和心血管疾病特异性死亡之间的关联。
我们从一项具有全国代表性的美国人群调查中获取了1599名CVD患者用于本研究。我们应用Kaplan-Meier曲线、调整加权Cox回归模型和限制性立方样条来研究LTL与全因死亡之间的关联。此外，我们采用竞争风险回归来评估LTL对心血管特异性死亡的影响，将非心血管死亡作为竞争事件。
在中位随访13.9年后，总死亡率为31.0%。LTL较短的患者全因死亡风险较高，调整后的风险比（HR）为1.25（95%置信区间（CI）：1.05 - 1.48）。限制性立方样条显示出线性剂量反应关系。在按性别分析中，LTL较短的女性患者死亡风险较高（加权HR，1.79；95%CI，1.29 - 2.48），而在男性中未观察到这种关联（加权HR，0.90；95%CI，0.61 - 1.32）。Fine-Gray竞争风险模型显示LTL与心血管特异性死亡率之间无显著关系，但与非心血管死亡有显著关联（调整后HR，1.24；95%CI，1.02 - 1.51）。
LTL与女性CVD患者的全因死亡呈负相关。LTL降低与全因死亡率增加之间的显著相关性强调了LTL作为心血管疾病三级预防潜在标志物的作用。
