Clonal Hematopoiesis Associated With High Risk of CVD Among Patients With MM Undergoing HCT

Results from a retrospective cohort study demonstrated that clonal hematopoiesis of indeterminate potential (CHIP) was both significantly and independently associated with risk of cardiovascular disease (CVD) among patients with multiple myeloma (MM) undergoing hematopoietic cell transplant (HCT).

Of the 1,036 consecutive patients with MM who underwent a first autologous HCT, 201 patients had at least 1 CHIP variant and 35 patients had 2 or more variants. It was determined that the 5-year incidence of CVD was significantly higher among patients with CHIP (21.1% vs 8.4%; P < .001) compared with those without CHIP. The 5-year incidence among those with 2 or more variants was 25.6%. 

In the multivariable model, CHIP was associated with an increased risk of CVD (hazard ratio [HR], 2.72; 95% confidence interval [CI], 1.70-4.39), as well as of individual outcomes of interest, which included heart failure (HR, 4.02; 95% CI, 2.32-6.98), coronary artery disease (HR, 2.22; 95% CI, 1.06-4.63), and stroke (HR, 3.02; 95% CI, 1.07-8.52). Patients who had both CHIP and preexisting hypertension or dyslipidemia were at nearly 7-fold and 4-fold increased risk of CVD, respectively.

June-Wha Rhee, MD, and colleagues concluded that, “ CHIP was significantly and independently associated with risk of CVD in patients with MM undergoing HCT and may serve as a novel biologically plausible biomarker for CVD in this cohort. Patients with MM and both CHIP and cardiovascular risk factors had an exceptionally high risk of CVD.”

“Additional studies are warranted to determine if cardiovascular preventive measures can reduce CHIP-associated CVD risk,” they added. 

Source:

Rhee J, Pillai R, He T, et al. Clonal hematopoiesis and cardiovascular disease in patients with multiple myeloma undergoing hematopoietic cell transplant. JAMA Cardiol. Published online November 8, 2023. doi:10.1001/jamacardio.2023.4105