Gamut of Patients Referred to Cardiology for Question of Clonal Hematopoiesis

Area of Science:

• Hematology
• Cardiology
• Genetics

Background:

• Clonal hematopoiesis (CH) involves somatic mutations in hematopoietic cells.
• CH is linked to aging, cytotoxic therapy, hematologic malignancy, and cardiovascular disease.
• Patients with CH are increasingly referred for cardiology evaluation.

Purpose of the Study:

• To characterize the spectrum of patients referred to cardiology for CH.
• To identify factors influencing cardiovascular risk in CH patients.
• To inform individualized cardiovascular risk assessment and mitigation strategies.

Main Methods:

• Retrospective review of patients referred for CH evaluation.
• Analysis of detection setting (incidental, workup, surveillance).
• Assessment of clone size, mutation burden, driver genes, and cardiovascular risk factors.

Main Results:

• CH detection varied: incidental, cytopenia/cancer workup, malignancy, post-therapy.
• High-risk features (large clone size, multiple mutations, specific drivers) interact with traditional risk factors.
• These interactions influence ischemic cardiovascular events.

Conclusions:

• Contextualizing CH by detection setting, genotype, and history is crucial.
• Informed evaluation and risk mitigation are essential for CH patients.
• Mechanistically targeted preventive strategies and clinical trial designs can be guided by these findings.