1. The predictive role of circulating telomerase and vitamin D for long-term survival in patients undergoing coronary artery bypass grafting surgery (CABG)
- Author
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M H Javanbakht, Saverio Stranges, Mahdi Najafi, Elnaz Movahedi, Mehdi Yaseri, Mahtab Zarei, Frank W. Sellke, Yun-Hee Choi, and Arash Shirvani
- Subjects
Male ,Telomerase ,Cardiovascular Procedures ,Myocardial Infarction ,Organic chemistry ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Iran ,Vascular Medicine ,Biochemistry ,Coronary artery disease ,0302 clinical medicine ,Medical Conditions ,Risk Factors ,Medicine and Health Sciences ,030212 general & internal medicine ,Myocardial infarction ,Vitamin D ,Coronary Artery Bypass ,Multidisciplinary ,Coronary Artery Bypass Grafting ,Chromosome Biology ,Vitamins ,Middle Aged ,C-Reactive Proteins ,Physical sciences ,Survival Rate ,Chemistry ,Telomeres ,Cardiovascular Diseases ,Cohort ,Medicine ,Female ,Research Article ,Cardiac function curve ,medicine.medical_specialty ,Chromosome Structure and Function ,Science ,Cardiology ,Surgical and Invasive Medical Procedures ,Chromosomes ,03 medical and health sciences ,Chemical compounds ,Organic compounds ,medicine ,Vitamin D and neurology ,Humans ,Vascular Diseases ,Survival rate ,Aged ,Proportional Hazards Models ,Proportional hazards model ,business.industry ,Biology and Life Sciences ,Proteins ,Cell Biology ,medicine.disease ,Surgery ,Peripheral Vascular Disease ,business ,Biomarkers - Abstract
Backgrounds Cardiovascular disease (CVD) is the leading cause of mortality all over the globe. Inflammation is believed to play a pivotal role in the pathophysiology of CVD. While there are studies on the interrelationship of telomerase and vitamin D and their involvement in CVD, their independent contributions to long-term outcomes in patients with CVD are not well-defined. This study aimed to investigate the association of both telomerase and vitamin D concentrations with 10-year survival among candidates of coronary artery bypass grafting (CABG) surgery. Methods Participants were 404 patients from Tehran Heart Center-Coronary Outcome Measurement (THC-COM) cohort who were recruited from CABG surgery candidates in 2006. In addition to demographic and clinical data including risk factors for coronary artery disease, laboratory parameters such as markers of inflammation as well as baseline serum 25-hydroxy vitamin D [25(OH)D] and telomerase concentrations were measured. Cardiac function indexes alongside outcome measures such as mortality and survival days were recorded for every patient up to 10 years after CABG. Cox-proportional hazard model was used to study the association between all-cause mortality and research parameters. Results The mean serum telomerase enzyme level was 24.92 ±21.4 nmol/L and the mean serum 25 (OH)D was 27.27±10.3 ng/mL. 10-year mortality was reported in 64 (15.8%) patients. 25 (OH)D was categorized into three groups (30) and the cut-point for telomerase was set at 25.0 nmol/L. In Cox regression analysis, higher levels of telomerase (>25 nmol/L) were significantly associated with longer survival (p = 0.041), whereas 25(OH)D concentrations were not associated with survival time. Further analysis showed that telomerase concentrations significantly predicted survival only in the presence of insufficient levels of 25(OH)D (20-30 ng/mL) (p = 0.037). Conclusions Telomerase can be regarded as a potential predictor of long-term outcomes in patients who underwent CABG. However, the association of telomerase with the mortality may be modified by vitamin D concentrations. Copyright
- Published
- 2020