Telomere length is independently associated with all-cause mortality in chronic heart failure

Simon P R Romaine* (Corresponding Author), Matthew Denniff, Veryan Codd, Mintu Nath, Andrea Koekemoer, Stefan D Anker, John G Cleland, Gerasimos Filippatos, Daniel Levin, Marco Metra, Ify R Mordi, Wouter Ouwerkerk, Jozine M Ter Maaten, Dirk J van Veldhuisen, Faiez Zannad, Leong L Ng, Pim van der Harst, Chim C Lang, Adriaan A Voors, Christopher P NelsonNilesh J Samani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


OBJECTIVE: Patients with heart failure have shorter mean leucocyte telomere length (LTL), a marker of biological age, compared with healthy subjects, but it is unclear whether this is of prognostic significance. We therefore sought to determine whether LTL is associated with outcomes in patients with heart failure.

METHODS: We measured LTL in patients with heart failure from the BIOSTAT-CHF Index (n=2260) and BIOSTAT-CHF Tayside (n=1413) cohorts. Cox proportional hazards analyses were performed individually in each cohort and the estimates combined using meta-analysis. Our co-primary endpoints were all-cause mortality and heart failure hospitalisation.

RESULTS: In age-adjusted and sex-adjusted analyses, shorter LTL was associated with higher all-cause mortality in both cohorts individually and when combined (meta-analysis HR (per SD decrease in LTL)=1.16 (95% CI 1.08 to 1.24); p=2.66×10-5), an effect equivalent to that of being four years older. The association remained significant after adjustment for the BIOSTAT-CHF clinical risk score to account for known prognostic factors (HR=1.12 (95% CI 1.05 to 1.20); p=1.04×10-3). Shorter LTL was associated with both cardiovascular (HR=1.09 (95% CI 1.00 to 1.19); p=0.047) and non-cardiovascular deaths (HR=1.18 (95% CI 1.05 to 1.32); p=4.80×10-3). There was no association between LTL and heart failure hospitalisation (HR=0.99 (95% CI 0.92 to 1.07); p=0.855).

CONCLUSION: In patients with heart failure, shorter mean LTL is independently associated with all-cause mortality.

Original languageEnglish
Pages (from-to)124-129
Number of pages6
Early online date31 Mar 2021
Publication statusPublished - 22 Dec 2021

Bibliographical note

Funding BIOSTAT-CHF was funded by a grant from the European Commission (FP7-242209-BIOSTAT-CHF).


  • biomarkers
  • genetics
  • heart failure


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