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 journalReview articlepeer-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 languageEnglish
Pages (from-to)567-577
Number of pages11
JournalJournal of the American College of Cardiology
Volume74
Issue number4
DOIs
StatePublished - Jul 30 2019

Keywords

  • cancer
  • cardio-oncology
  • cardiovascular risk
  • leukemia
  • leukocyte

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