The predictive role of circulating telomerase and vitamin D for long-term survival in patients undergoing coronary artery bypass grafting surgery (CABG)

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.

Blood Urea Nitrogen-to-Albumin Ratio in Predicting Long-Term Mortality in Patients Following Coronary Artery Bypass Grafting: An Analysis of the MIMIC-III Database

“…This procedure has been performed for more than 40 years to alleviate symptoms and reduce the risk of death in ischemic heart disease (2). While a substantial reported literature on risk assessment following CABG has mainly focused on short-and midterm mortality, few studies have examined predictive indicators for long-term postoperative mortality (3,4).…”

Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

“…Those results were consistent with those of our study, but pooled results had great heterogeneity. Other studies have reported postoperative adverse outcomes, such as intubation duration ( 2 , 5 , 19 , 23 , 31 , 37 ), hospitalization duration ( 5 , 20 , 31 , 37 ), mortality ( 2 , 31 , 34 , 35 ), and found a significant association with the VitD level. However, pooled analysis was prohibited by few studies.…”

The Association between 25-Hydroxyvitamin D Concentration and Telomere Length in the Very-Old: The Newcastle 85+ Study

“…Generally, an activated form of vitamin D has autocrine and paracrine roles, including reducing telomere shortening through both anti-inflammatory and antiproliferative mechanisms. First, the active form of vitamin D decreases the mediators of systemic inflammation, such as interleukin-2 and tumor necrosis factor [9]. Furthermore, vitamin D receptor is expressed in the T and B lymphocytes, natural killer cells, and monocytes, which promote the down-regulation of cytokines and other proinflammatory factors.…”

“…Limited population studies have assessed the association between circulating 25(OH)D concentration [the most commonly used nutritional biomarker of vitamin D] and telomere length [4,[8][9][10][11][12][13][14][15][16]. A recent study [9] demonstrated that only at insufficient concentrations of 25(OH)D (50-75 nmol/L), telomerase activity is associated with survival times in CHD patients (mean age 59.9 years-old). The findings by Richards et al [10] and Liu et al [11] demonstrated a positive association between 25(OH)D concentration and leukocyte telomere length (LTL) in women.…”