title: Short Leukocyte Telomere Length Is Associated With Cardioembolic Stroke Risk in Patients With Atrial Fibrillation.
abstract: OBJECTIVE
  The risk of cardioembolic stroke in patients with atrial fibrillation (AF) cannot be accurately assessed and novel tools are needed to improve prediction. We hypothesize that telomere shortening constitutes a novel risk factor for cardioembolic stroke in patients with AF.
  
  
  METHODS
  The peripheral blood leukocyte telomere length (LTL) was determined by real-time polymerase chain reaction in 187 patients with AF, 93 of them without stroke history and 94 of them having suffered 1 cardioembolic stroke. Percentiles were calculated according to LTL values in the nonstroke group to estimate the cardioembolic stroke risk associated with LTL using logistic regression models.
  
  
  RESULTS
  Short LTL values were independently and dose-dependently associated with an increased risk of cardioembolic stroke, with an odds ratio (95% confidence interval) of 2.93 (1.24-6.94) and 6.26 (2.01-19.52), respectively, for sex, hypertension, diabetes mellitus, heart failure, and age-adjusted models using the LTL 10th and 5th percentile cut-offs, respectively.
  
  
  CONCLUSIONS
  Telomere shortening is associated with cardioembolic stroke risk in patients with AF. Prospective studies are encouraged to establish the value of LTL to improve prediction tools to categorize cardioembolic stroke risk in AF.
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.).
authors.forename: Mikel
authors.initials: M
authors.lastname: Allende
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.).
authors.forename: Eva
authors.initials: E
authors.lastname: Molina
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.).
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Porras
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.).
authors.forename: Estefanía
authors.initials: E
authors.lastname: Toledo
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.).
authors.forename: Ramón
authors.initials: R
authors.lastname: Lecumberri
authors.affiliation: From the Cardiovascular Sciences Program, Center for Applied Medical Research (CIMA), Navarra's Health Research Institute (IdiSNA), University of Navarra, Pamplona, Spain (M.A., E.M., J.H.); Department of Haematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain (J.R.G.-P.); Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain (E.T.); and Hematology Service, University Clinic of Navarra, IdiSNA, Pamplona, Spain (R.L.). jhermida@unav.es.
authors.forename: José
authors.initials: J
authors.lastname: Hermida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology; D004617:Embolism / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000502:physiology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology; D059506:Telomere Shortening / Q000502:physiology*
keywords: atrial fibrillation; diabetes mellitus; heart failure; leukocytes; stroke