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Updated: Jun 18, 2026

Bone Marrow Transplantation Procedures in Mice to Study Clonal Hematopoiesis
08:00

Bone Marrow Transplantation Procedures in Mice to Study Clonal Hematopoiesis

Published on: May 26, 2021

Association Between Clonal Hematopoiesis and Cardiometabolic Disease: A Systematic Review and Meta-Analysis

Brooke D'Mello1, Neel Sheth2, Ani Orchanian-Cheff3

  • 1Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Temerty Faulty of Medicine, University of Toronto, Toronto, Ontario, Canada.

JACC. Cardiooncology
|June 17, 2026
PubMed

Insights

Clonal hematopoiesis (CH) is linked to increased risks of heart attack, stroke, and type 2 diabetes. Specific gene mutations within CH may further elevate cardiovascular mortality risks.

Area of Science:

  • Hematology
  • Genomics
  • Cardiology
  • Endocrinology

Background:

  • Clonal hematopoiesis (CH) involves age-related expansion of hematopoietic stem cells with mutations.
  • CH is linked to overall mortality, primarily cardiovascular disease, but its specific cardiometabolic endpoint associations are unclear.

Purpose of the Study:

  • To systematically quantify associations between CH and incident myocardial infarction, stroke, cardiovascular mortality, and type 2 diabetes.
  • To assess if these associations vary based on CH driver gene mutations.

Main Methods:

  • Systematic review and meta-analysis of observational studies (MEDLINE, Embase, Cochrane, CENTRAL) up to June 2025.
  • Inclusion of studies reporting age-adjusted associations between CH and cardiometabolic outcomes in adults.
  • Random-effects models used to generate hazard ratios (HRs); risk of bias assessed via Newcastle-Ottawa Scale.

Main Results:

  • Eighteen studies with over 650,000 participants showed CH is associated with increased myocardial infarction (HR: 1.14), stroke (HR: 1.12), cardiovascular mortality (HR: 1.20), and type 2 diabetes (HR: 1.20).
  • TET2 mutations were linked to higher stroke hazard (HR: 1.41), and ASXL1 mutations to increased cardiovascular mortality (HR: 2.22).

Conclusions:

  • CH is associated with significant cardiometabolic outcomes, suggesting its role as a somatic genomic marker for cardiometabolic risk.
  • Heterogeneity in CH definitions necessitates cautious interpretation and further research into mutation-specific and phenotype-specific risks.
Abstract

Keywords:
cardiovascular diseaseclonal hematopoiesisclonal hematopoiesis of indeterminate potentialcoronary artery diseasediabetesgeneticsischemic diseasemosaic chromosomal alterationstype 2 diabetes

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