Clonal haematopoiesis and cardiovascular diseases: A growing relationship

Arch Cardiovasc Dis. 2021 Apr;114(4):316-324. doi: 10.1016/j.acvd.2021.01.002. Epub 2021 Mar 10.

Abstract

Cardiovascular diseases, particularly atherothrombosis, are the leading cause of death worldwide, but their mechanisms are not yet fully understood. Traditional cardiovascular risk factors have been known for many years, but are not enough to predict individual risk. Clonal haematopoiesis of indeterminate potential (CHIP) has been described recently; it corresponds to the clonal expansion of a population of haematopoietic cells in response to the acquisition of a somatic mutation, without any clinical or biological sign of haematological malignancy. The prevalence of this condition increases with age, reaching 10-20% of the general population aged>70 years. Recent observational studies have shown a link between CHIP and cardiovascular diseases in humans, revealing that CHIP carriers have a higher risk of myocardial infarction, heart failure and severe aortic valve stenosis. The prognosis of these conditions also seems to be altered by the presence of CHIP. Experimental studies have identified that the immune system and inflammation - particularly interleukin-1β-secreting macrophages - play a critical role in enhancing the cardiovascular consequences of CHIP, through their action on the atherosclerotic plaque and myocardial tissues. We aimed to write an extensive review of what is currently known about CHIP and its cardiovascular consequences, the pathophysiological mechanisms leading to the increased cardiovascular risk and, finally, the expected influence on our daily practice and how we care for patients with CHIP.

Keywords: Atherosclerosis; Athérosclérose; Cardiovascular diseases; Facteurs de risque; Haematopoiesis; Hématopoïèse; Inflammation; Maladies cardiovasculaires; Risk factors.

Publication types

  • Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Animals
  • Cardiovascular Diseases / genetics
  • Cardiovascular Diseases / immunology
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / pathology*
  • Clonal Hematopoiesis* / genetics
  • Female
  • Heart Disease Risk Factors
  • Hematopoietic Stem Cells / immunology
  • Hematopoietic Stem Cells / metabolism
  • Hematopoietic Stem Cells / pathology*
  • Humans
  • Inflammation Mediators / metabolism
  • Male
  • Middle Aged
  • Mutation
  • Prognosis
  • Risk Assessment
  • Young Adult

Substances

  • Inflammation Mediators