Short telomere length in blood leukocytes contributes to the presence of atherothrombotic stroke and hemorrhagic stroke and risk of post-stroke death.

ABSTRACT Background-Inter-individual differences in biological ageing could affect susceptibility to stroke. To date, the relationship between stroke and telomere shortening remain inconclusive; and sparse data is available to hemorrhagic stroke. Methods and Results- A Chinese case-control study was conducted, comprising 1756 cases (767 atherothrombosis, 494 lacunar infarction, and 486 hemorrhagic strokes) and 1801 controls. Stroke patients were prospectively followed up for median 4.5 (range, 0.1-6.0) years. Individuals with shorter telomere length had a higher presence of atherothrombotic stroke (multivariate odds ratio [OR] 1.37, 95%CI 1.06-1.77; P=0.015) or hemorrhagic stroke (multivariate OR 1.48, 95%CI 1.08-2.02; P=0.016) in comparison of the lowest to highest tertile of telomere length. Particularly, in persons with family history of stroke, there were remarkably increased presence of 2.55-fold for atherothrombotic stroke (95%CI 1.87-3.48; P trend<0.0001) and 2.33-fold for hemorrhagic stroke (95%CI 1.62-3.36; P trend<0.0001). During the follow-up, 338 recurrent strokes and 312 deaths (181 from stroke or coronary heart disease and 131 from other causes) were documented. Associations with stroke recurrence were not observed in the follow-up patients, while atherothrombotic stroke cases with shorter telomeres had 69% increased risk of post-stroke death (relative risk 1.69, 95%CI 1.07-2.67; P=0.02). Finally, we compared telomere lengths in 12 paired samples of circulating leukocytes and carotid atherosclerotic plaques from patients undergoing carotid endarterectomy, there was a positive correlation between vessel wall tissue and leukocyte telomere length. Conclusions-Shorter telomere length may serve as a potential marker for the presence of atherothrombotic and hemorrhagic stroke and for the risk of post-stroke death.
PMID: 23323942