TY - JOUR
T1 - Accelerated Biological Aging Secondary to Cardiometabolic Risk Factors Is a Predictor of Cardiovascular Mortality
T2 - A Systematic Review and Meta-analysis
AU - Emami, Mehrdad
AU - Agbaedeng, Thomas A.
AU - Thomas, Gijo
AU - Middeldorp, Melissa E.
AU - Thiyagarajah, Anand
AU - Wong, Christopher X.
AU - Elliott, Adrian D.
AU - Gallagher, Celine
AU - Hendriks, Jeroen M.L.
AU - Lau, Dennis H.
AU - Sanders, Prashanthan
N1 - Funding Information:
Dr Lau reports the University of Adelaide has received on his behalf lecture and/or consulting fees from Abbott Medical, Bayer, Biotronik, Boehringer Ingelheim, Medtronic, Microport and Pfizer/BMS. Dr Sanders reports having served on the advisory board of Medtronic, Abbott Medical, Boston Scientific, CathRx and PaceMate. Dr Sanders reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Medtronic, Abbott Medical, and Boston Scientific. Dr Sanders reports that the University of Adelaide has received on his behalf research funding from Medtronic, Abbott Medical, Boston Scientific, and Microport. All other authors have no disclosures.
Funding Information:
Dr Emami and Thiyagarajah are supported by postgraduate scholarships from the University of Adelaide. Drs Agbaedeng, Thomas, Middeldorp and Gallagher are supported by Postdoctoral Fellowships from the University of Adelaide. Drs Elliott and Hendriks are supported by a Future Leader Fellowship from the National Heart Foundation of Australia. Dr Sanders is supported by Practitioner Fellowships from the National Health and Medical Research Council of Australia.
Publisher Copyright:
© 2022
PY - 2022/3
Y1 - 2022/3
N2 - Background: Chronological aging is one of the major risk factors of cardiovascular (CV) disease (CVD); however, the effect of biological aging on CVD and outcomes remain poorly understood. Herein, we evaluated the association between leukocyte telomere length (LTL), a marker of biological age, and CV outcomes. Methods: We searched PubMed, Embase, Ovid Medline, and Web of Science Core Collection for the studies on the association between LTL and myocardial infarction (MI), CV death, and/or CVD risk factors from inception to July 2020. Extracted data were pooled in a random-effects meta-analysis and summarized as risk ratio (RR) and corresponding 95% confidence interval (CI) per LTL tertile. Results: A total of 32 studies (n = 144,610 participants) were included. In a pooled analysis of MI and LTL in a multivariate-adjusted model, the shortest LTL was associated with a 39% higher risk of MI (RR, 1.39; 95% CI, 1.16-1.67; P < 0.001). After adjusting for chronological age and traditional covariance, we showed a 28% increased risk of CV death in the shortest tertile of LTL (RR, 1.28; 95% CI, 1.05-1.56; P = 0.01). Analysis of the studies that investigated the association between CV risk factors and LTL (n = 7) showed that diabetes mellitus is associated with a 46% increased risk of LTL attrition (RR, 1.46; 95% CI, 1.46-2.09; P = 0.039). Conclusions: This study shows a strong association between LTL, a marker of biological aging, and the risk of MI and CV death. Cardiometabolic risk factors contribute to telomere attrition and therefore accelerates biological aging.
AB - Background: Chronological aging is one of the major risk factors of cardiovascular (CV) disease (CVD); however, the effect of biological aging on CVD and outcomes remain poorly understood. Herein, we evaluated the association between leukocyte telomere length (LTL), a marker of biological age, and CV outcomes. Methods: We searched PubMed, Embase, Ovid Medline, and Web of Science Core Collection for the studies on the association between LTL and myocardial infarction (MI), CV death, and/or CVD risk factors from inception to July 2020. Extracted data were pooled in a random-effects meta-analysis and summarized as risk ratio (RR) and corresponding 95% confidence interval (CI) per LTL tertile. Results: A total of 32 studies (n = 144,610 participants) were included. In a pooled analysis of MI and LTL in a multivariate-adjusted model, the shortest LTL was associated with a 39% higher risk of MI (RR, 1.39; 95% CI, 1.16-1.67; P < 0.001). After adjusting for chronological age and traditional covariance, we showed a 28% increased risk of CV death in the shortest tertile of LTL (RR, 1.28; 95% CI, 1.05-1.56; P = 0.01). Analysis of the studies that investigated the association between CV risk factors and LTL (n = 7) showed that diabetes mellitus is associated with a 46% increased risk of LTL attrition (RR, 1.46; 95% CI, 1.46-2.09; P = 0.039). Conclusions: This study shows a strong association between LTL, a marker of biological aging, and the risk of MI and CV death. Cardiometabolic risk factors contribute to telomere attrition and therefore accelerates biological aging.
UR - http://www.scopus.com/inward/record.url?scp=85122633071&partnerID=8YFLogxK
U2 - 10.1016/j.cjca.2021.10.012
DO - 10.1016/j.cjca.2021.10.012
M3 - Review article
C2 - 34822967
AN - SCOPUS:85122633071
VL - 38
SP - 365
EP - 375
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
SN - 0828-282X
IS - 3
ER -