Telomere Length and Cardiovascular Risk Factors Relationship in Coronary Artery Disease With Borderline Coronary Artery Stenosis Patients

Highlights Telomere length and cardiovascular risk factors relationship in stable coronary artery disease patients with borderline coronary arteries stenosis with and without metabolic risk factors (diabetes mellitus and obesity) indicate complex and various mechanisms of coronary artery disease development in this category patients. Abstract Aim. To identify the relationship between telomere length and cardiovascular risk factors in patients with different clinical phenotypes of coronary artery disease (CAD) with borderline stenosis of the coronary arteries (CA). Methods. The study included 201 patients with stable angina 1–3 class and borderline (50–70%) CA stenosis. Patients underwent physical examination, clinical and biochemical blood tests, assessment of systemic inflammation markers and atherosclerotic plaque stability, genetic markers (relative telomere length (RTL) was determined by real-time PCR), instrumental studies (ECG, ultrasound of the heart, neck vessels, coronary angiography, determination of stiffness markers, moreover, cognitive functions and the presence of early vascular aging (EVA) were assessed. Statistical calculations were performed using the RStudio program. Pairwise associations between two continuous variables were investigated by calculating Spearman`s correlation coefficients, between other types of variables it was investigated by using biserial correlation coefficients. Testing of statistical hypotheses was performed at a critical significance level of p = 0.05, i.e. the difference was considered statistically significant if p < 0.05. Results. The 1st group consisted of patients with stable CAD phenotype without diabetes mellitus (DM) and obesity (71 (35.3%) patients), the 2nd group consisted of patients with stable CAD phenotype and type 2 DM (51 (25.4%) patients), the 3rd group consisted of patients with stable CAD phenotype and metabolically unhealthy obesity phenotype (MUO) (79 (39.3%) patients). When assessing the correlation relationships in the group of patients with the stable CAD phenotype without DM and MUO, the telomere length (TL) indicator correlated positively with the augmentation index (p = 0.036) and negatively with the number of points on the MMSE scale (p = 0.045), with the level of IL-1 (p = 0.022), with the level of MMP-9 (p = 0.040). In the group of patients with the stable CAD phenotype and diabetes mellitus, negative correlations were found between the TL and the levels of TC (p < 0.001), LDL (p = 0.001), the presence of right coronary artery (RCA) lesion (p = 0.025), the level of MMP-9 (p = 0.035), tEAT (p = 0.044) and the level of micro-RNA-208a (p < 0.001) and positive correlations with the age of myocardial infarction (p = 0.023), the level of blood urea (p = 0.005) and the level of micro-RNA-21 (p = 0.019). In the group of patients with the stable CAD phenotype and MNF, the TL indicators positively correlated with the presence of lesion of the anterior descending artery (p = 0.018) and RCA (p = 0.018). Conclusion. The revealed correlation relationships of TL with various cardiovascular risk factors indicate complex mechanisms of development of coronary artery disease with borderline stenosis of the coronary arteries.