Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Telomere length and stroke recurrence after ischemic stroke and TIA
First author：Zhang Xing
Corresponding author：Wang Yongjun
essential_information
- Person in charge：Zhang Xing
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20210111
- Published time：2022-05-19
2022-05-19
Published articles
Journal：International journal of stroke
Publication type: Original Contributions
IF(IF): 6.948
PMID: 35422196 Link To Pubmed Full text Download
Background And Purpose
Telomere is a key biomarker for cell division and senescence, which is closely related to cellular aging. Abundant evidence supported that telomere length shortening is associated with incidence of aging-related diseases, including cardiovascular disease. However, there are limited studies have investigated association between telomere length and outcomes after stroke. A few studies supported that telomere length maybe a prognostic marker for post-stroke cognitive impairment, dementia, and death, while no data relating to association of telomere length with recurrent event and disability was found. We aim to assess the potential value of telomere length as a maker to predict stroke outcomes, including post-stroke cognitive impairment, stroke recurrence, and functional prognosis.
Method
Patients from the Third China National Stroke Registry who had whole genome sequencing (WGS) were selected. TL was estimated using TelSeq based on binary sequence alignment/map files derived from WGS data. Cox proportional hazards regression models were performed to assess the association of TL with recurrent stroke.
Conclusion
In Chinese IS or TIA patients, no independent association was found between TL and risk of stroke recurrence after adjusting for co-variates. We found a possible association in older patients but this needs replicating.
Main results
A total of 8041 patients with ischemic stroke (IS) or transient ischemic attack (TIA) were included. Mean TL was 2.14 ± 0.82 kb. Patients in the lowest tertile of TL had higher incidence of stroke recurrence compared to those in the middle and highest tertile (6.4% vs 5.9% vs 5.2%), but the difference was not longer significant after adjusting for age, sex, cardiovascular risk factors and stroke severity. Similarly, when analyzing TL as a continuous variable, the HR per 1000 bp increase in TL was significant 0.88 (0.79–0.98), but after adjusting for co-variates, was no longer significant (0.91; 95% confidence interval (CI), 0.81–1.02). In patients aged > 65 years, but not in younger patients, after adjusting for co-variates, TL was significantly associated with stroke recurrence. Compared to the lowest tertile, HRs (95% CI) after adjustment for all co-variates for the middle and highest tertiles were 0.78 (0.55–1.10) and 0.67 (0.46–0.98), respectively, with p for trend of 0.03. In analyses using TL as a continuous variable, adjusted HR (95% CI) per 1000 bp increase in TL was 0.80 (0.66–0.96). However, there was no significant interaction between TL and age on risk of stroke recurrence (p for interaction = 0.09).