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Updated: Mar 10, 2026
Telomere Length and Telomerase Activity; A Yin and Yang of Cell Senescence
Published on: May 22, 2013
Telomere Shortening, Regenerative Capacity, and Cardiovascular Outcomes
Muhammad Hammadah1, Ibhar Al Mheid1, Kobina Wilmot1
1From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.).
Rationale:
Leukocyte telomere length (LTL) is a biological marker of aging, and shorter LTL is associated with adverse cardiovascular outcomes. Reduced regenerative capacity has been proposed as a mechanism. Bone marrow-derived circulating progenitor cells are involved in tissue repair and regeneration.
Objective:
Main objective of this study was to examine the relationship between LTL and progenitor cells and their impact on adverse cardiovascular outcomes.
Methods And Results:
We measured LTL by quantitative polymerase chain reaction in 566 outpatients (age: 63±9 years; 76% men) with coronary artery disease. Circulating progenitor cells were enumerated by flow cytometry. After adjustment for age, sex, race, body mass index, smoking status, and previous myocardial infarction, a shorter LTL was associated with a lower CD34+ cell count: for each 10% shorter LTL, CD34+ levels were 5.2% lower (P<0.001). After adjustment for the aforementioned factors, both short LTL (
Conclusions:
Although shorter LTL is associated with decreased regenerative capacity, both LTL and circulating progenitor cell levels are independent and additive predictors of adverse cardiovascular outcomes in coronary artery disease patients. Our results suggest that both biological aging and reduced regenerative capacity contribute to cardiovascular events, independent of conventional risk factors.
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