Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week

Peter Libby; Robert Sidlow; Amy E. Lin; Dipti Gupta; Lee W. Jones; Javid Moslehi; Andreas Zeiher; Siddhartha Jaiswal; Christian Schulz; Ron Blankstein; Kelly L. Bolton; David Steensma; Ross L. Levine; Benjamin L. Ebert

doi:10.1016/j.jacc.2019.06.007

Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week

Peter Libby, Robert Sidlow, Amy E. Lin, Dipti Gupta, Lee W. Jones, Javid Moslehi, Andreas Zeiher, Siddhartha Jaiswal, Christian Schulz, Ron Blankstein, Kelly L. Bolton, David Steensma, Ross L. Levine, Benjamin L. Ebert

Research output: Contribution to journal › Review article › peer-review

113 Scopus citations

Abstract

A novel, common, and potent cardiovascular risk factor has recently emerged: clonal hematopoiesis of indeterminate potential (CHIP). CHIP arises from somatic mutations in hematopoietic stem cells that yield clonal progeny of mutant leukocytes in blood. Individuals with CHIP have a doubled risk of coronary heart disease and ischemic stroke, and worsened heart failure outcomes independent of traditional cardiovascular risk factors. The recognition of CHIP as a nontraditional risk factor challenges specialists in hematology/oncology and cardiovascular medicine alike. Should we screen for CHIP? If so, in whom? How should we assess cardiovascular risk in people with CHIP? How should we manage the excess cardiovascular risk in the absence of an evidence base? This review explains CHIP, explores the clinical quandaries, strives to provide reasonable recommendations for the multidisciplinary management of cardiovascular risk in individuals with CHIP, and highlights current knowledge gaps.

Original language	English
Pages (from-to)	567-577
Number of pages	11
Journal	Journal of the American College of Cardiology
Volume	74
Issue number	4
DOIs	https://doi.org/10.1016/j.jacc.2019.06.007
State	Published - Jul 30 2019

Keywords

cancer
cardio-oncology
cardiovascular risk
leukemia
leukocyte

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Libby, P., Sidlow, R., Lin, A. E., Gupta, D., Jones, L. W., Moslehi, J., Zeiher, A., Jaiswal, S., Schulz, C., Blankstein, R., Bolton, K. L., Steensma, D., Levine, R. L., & Ebert, B. L. (2019). Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week. Journal of the American College of Cardiology, 74(4), 567-577. https://doi.org/10.1016/j.jacc.2019.06.007

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title = "Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week",

abstract = "A novel, common, and potent cardiovascular risk factor has recently emerged: clonal hematopoiesis of indeterminate potential (CHIP). CHIP arises from somatic mutations in hematopoietic stem cells that yield clonal progeny of mutant leukocytes in blood. Individuals with CHIP have a doubled risk of coronary heart disease and ischemic stroke, and worsened heart failure outcomes independent of traditional cardiovascular risk factors. The recognition of CHIP as a nontraditional risk factor challenges specialists in hematology/oncology and cardiovascular medicine alike. Should we screen for CHIP? If so, in whom? How should we assess cardiovascular risk in people with CHIP? How should we manage the excess cardiovascular risk in the absence of an evidence base? This review explains CHIP, explores the clinical quandaries, strives to provide reasonable recommendations for the multidisciplinary management of cardiovascular risk in individuals with CHIP, and highlights current knowledge gaps.",

keywords = "cancer, cardio-oncology, cardiovascular risk, leukemia, leukocyte",

author = "Peter Libby and Robert Sidlow and Lin, {Amy E.} and Dipti Gupta and Jones, {Lee W.} and Javid Moslehi and Andreas Zeiher and Siddhartha Jaiswal and Christian Schulz and Ron Blankstein and Bolton, {Kelly L.} and David Steensma and Levine, {Ross L.} and Ebert, {Benjamin L.}",

note = "Publisher Copyright: {\textcopyright} 2019 American College of Cardiology Foundation",

year = "2019",

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doi = "10.1016/j.jacc.2019.06.007",

language = "English",

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Libby, P, Sidlow, R, Lin, AE, Gupta, D, Jones, LW, Moslehi, J, Zeiher, A, Jaiswal, S, Schulz, C, Blankstein, R, Bolton, KL, Steensma, D, Levine, RL & Ebert, BL 2019, 'Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week', Journal of the American College of Cardiology, vol. 74, no. 4, pp. 567-577. https://doi.org/10.1016/j.jacc.2019.06.007

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T2 - Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week

AU - Libby, Peter

AU - Sidlow, Robert

AU - Lin, Amy E.

AU - Gupta, Dipti

AU - Jones, Lee W.

AU - Moslehi, Javid

AU - Zeiher, Andreas

AU - Jaiswal, Siddhartha

AU - Schulz, Christian

AU - Blankstein, Ron

AU - Bolton, Kelly L.

AU - Steensma, David

AU - Levine, Ross L.

AU - Ebert, Benjamin L.

PY - 2019/7/30

Y1 - 2019/7/30

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AB - A novel, common, and potent cardiovascular risk factor has recently emerged: clonal hematopoiesis of indeterminate potential (CHIP). CHIP arises from somatic mutations in hematopoietic stem cells that yield clonal progeny of mutant leukocytes in blood. Individuals with CHIP have a doubled risk of coronary heart disease and ischemic stroke, and worsened heart failure outcomes independent of traditional cardiovascular risk factors. The recognition of CHIP as a nontraditional risk factor challenges specialists in hematology/oncology and cardiovascular medicine alike. Should we screen for CHIP? If so, in whom? How should we assess cardiovascular risk in people with CHIP? How should we manage the excess cardiovascular risk in the absence of an evidence base? This review explains CHIP, explores the clinical quandaries, strives to provide reasonable recommendations for the multidisciplinary management of cardiovascular risk in individuals with CHIP, and highlights current knowledge gaps.

KW - cancer

KW - cardio-oncology

KW - cardiovascular risk

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Clonal Hematopoiesis: Crossroads of Aging, Cardiovascular Disease, and Cancer: JACC Review Topic of the Week

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