Coronary Heart Disease Risk Increased With Clonal Hematopoiesis

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Carriers of CHIP had a 1.9-fold increased risk of coronary heart disease vs noncarriers.
Carriers of CHIP had a 1.9-fold increased risk of coronary heart disease vs noncarriers.

HealthDay News — The presence of clonal hematopoiesis of indeterminate potential (CHIP) is associated with coronary heart disease, according to research published online in the New England Journal of Medicine.

Siddhartha Jaiswal, MD, from Massachusetts General Hospital in Boston, and colleagues used whole-exome sequencing to detect the presence of CHIP in peripheral blood cells, and its correlation with coronary heart disease. Samples were obtained from four case-control studies with 4726 participants with coronary heart disease and 3529 controls.

The researchers found that carriers of CHIP had a 1.9-fold increased risk of coronary heart disease vs noncarriers in nested case-control analyses from two prospective cohorts. Participants with CHIP had a four-fold increased risk compared with noncarriers in two retrospective case-control cohorts for evaluation of early-onset myocardial infarction. 

There were associations for mutations in DNMT3A, TET2, ASXL1, and JAK2 with coronary heart disease. Increased coronary artery calcification was seen for CHIP carriers with these mutations. Larger atherosclerotic lesions in the aortic root and aorta were seen in hypercholesterolemia-prone mice that were engrafted with bone marrow obtained from homozygous or heterozygous Tet2 knockout mice. Elevated expression of several chemokine and cytokine genes that contribute to atherosclerosis were seen in analyses of macrophages from Tet2 knockout mice.

"The presence of CHIP in peripheral-blood cells was associated with nearly a doubling in the risk of coronary heart disease in humans and with accelerated atherosclerosis in mice," the authors write.

Reference

Jaiswal S, Natarajan P, Silver AJ, et al. Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease [published online June 21, 2017]. N Engl J Med. doi: 10.1056/NEJMoa1701719.

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