Elevated Serum Telomerase Level and Peripheral Blood hTERT Gene Expression in Patients with Stable Coronary Artery Disease

Background/Objectives: Telomeres and telomerase play crucial roles in cellular aging and genome stability. Emerging evidence indicates that alterations in telomerase activity and telomerase reverse transcriptase (hTERT) gene expression may be involved in cardiovascular pathophysiology. However, data on telomerase regulation in patients with stable coronary artery disease (CAD) are limited. This study aimed to compare serum telomerase concentration and hTERT gene expression levels between patients with stable CAD and healthy controls. Methods: A total of 52 patients diagnosed with stable CAD and 50 age-matched healthy controls were enrolled prospectively. Telomerase concentrations were measured in serum samples using the ELISA method, and hTERT mRNA expression was measured in blood samples using RT-PCR. Results: Serum telomerase levels were significantly higher in patients with stable CAD compared with controls (p < 0.05). Similarly, hTERT gene expression was upregulated in the patient group (p < 0.05). Multivariable analysis showed that increased log-transformed telomerase levels (AOR: 2.12, 95% CI: 1.14–5.13, p = 0.024) and hTERT expression (AOR: 1.79, 95% CI: 1.09–3.27, p = 0.037) were independently associated with coronary vessel involvement in stable CAD. These findings indicate an increase in both telomerase level and hTERT transcriptional activity in stable CAD. Conclusions: Increased telomerase level and hTERT expression may reflect a compensatory response to chronic vascular stress and are associated with disease severity in stable CAD.