CHIP in cardiovascular disease

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Clonal hematopoiesis of indeterminate potential (CHIP) in cardiovascular disease

Clonal hematopoiesis is a population of related myeloid cells proliferating with an acquired gene mutation. When it is not associated with myelodysplastic syndrome, leukemia or any detectable hematological malignancy, it is called clonal hematopoiesis of indeterminate potential (CHIP).

CHIP is thought to have a role in premature cardiovascular events. It has been thought to be involved in atherosclerosis and degenerative aortic stenosis [1]. CHIP has been shown to increase with age. DNMT3A and TET2 were the most commonly mutated CHIP genes which regulate the inflammatory potential of circulating leukocytes. In a study by Mas-Peiro S et al, it was noted that those with these mutations had a profoundly increased medium term all cause mortality after successful TAVI (Transcatheter Aortic Valve Implantation) [2]. The mutations were detected in one third of the 279 patients undergoing TAVI. Among these, while the incidence was 25% in the age group of 55-69 years, it was much higher (52.9%) in the very elderly (90-100 years).

Please note that there is another, possibly better known CHIP in cardiology; Complex High-risk Indicated Procedure (Coronary Intervention)!

References

  1. Lin AE, Libby P, Ebert BL. A new opening on aortic stenosis: predicting prognosis with clonal haematopoiesis. Eur Heart J. 2020 Feb 21;41(8):940-942.
  2. Mas-Peiro S, Hoffmann J, Fichtlscherer S, Dorsheimer L, Rieger MA, Dimmeler S, Vasa-Nicotera M, Zeiher AM. Clonal haematopoiesis in patients with degenerative aortic valve stenosis undergoing transcatheter aortic valve implantation. Eur Heart J. 2020 Feb 21;41(8):933-939.