Objective: To investigate the association between genetic variation in telomerase RNA component (TERC) and leukocyte telomere length (LTL) with risk of coronary heart disease (CHD). Methods and results: An analysis of LTL was conducted, focusing on two SNPs in 2 community-based cohort populations comprising 3500 Chinese Han individuals. In addition, LTL ratio was determined in a case-control setting involving 4351 participants: 2211 healthy individuals and 2140 CHD patients. The association between LTL and the presence and extent of cardiovascular and cerebrovascular lesions were tested. Results confirmed the association of rs12696304 and rs16847897 with LTL in the Chinese Han population (P = 1.63 x 10(-6) and P = 1.44 x 10(-7), respectively). However, these SNPs confer a moderate risk for CHD but did not achieve significant threshold after multiple corrections. Decreased LTL ratio was associated with CHD (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.02-1.34; P < 0.01). In addition, the LTL ratio in CHD patients was related to numbers of vascular disease lesions. Conclusions: Our results do not support a causal role of LTL for the development of CHD. However, LTL may be related to complex conditions associated with cardiovascular and cerebrovascular disease manifestations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.