LAUSR

Identifying patients with stable coronary artery disease (CAD) at high risk for future heart attacks or death remains a challenge for all cardiologists. The study entitled Telomere Shortening, Regenerative Capacity, and Cardiovascular Outcomes in this issue has shed new light in the field.1 Hammadah et al1 focused on the relationship between circulating CD34+ cell levels, telomere length, and cardiovascular outcomes in subjects with stable CAD. Their study yielded 2 novel findings: (1) 10% shorter telomeres correlated with 5% lower levels of circulating CD34+ cells and (2) both short leukocyte telomere length (LTL) and low CD34+ cell levels independently predict adverse cardiovascular disease (CVD) outcomes (death, myocardial infarction [MI], coronary revascularization, or cerebrovascular events). Measurements of LTL and circulating CD34+ cells may facilitate risk stratification of patients with stable CAD distinct from traditional CVD risk factors. Prior studies reported associations between shortened LTL and CVD,2 and postulated that decreased regenerative capacity may be a primary cause of CVD events. The study by Hammadah et al1 is the first and largest study to test the hypothesis that LTL may be linked to the levels of CD34+ cells as a surrogate for regenerative capacity, and correlate these measures with CVD events. Article, see p 1130 Telomeres prevent chromosome ends from being recognized as a DNA break and activating DNA damage response pathways …