The presence of clonal hematopoiesis of indeterminate potential in patients with chronic kidney disease was independently associated with an increased risk of adverse clinical events (HR 2.02; 95% CI 1.11-3.67; P=0.022).
Cohort (n=151)
Does the presence of CHIP increase the risk of severe coronary lesions and adverse clinical events in patients with CKD undergoing coronary angiography?
In patients with CKD undergoing coronary angiography, the presence of CHIP is independently associated with more severe coronary lesions and a higher risk of adverse clinical events.
Effect estimate: HR 2.02 (95% CI 1.11-3.67)
p-value: p=0.022
Abstract Background Patients with chronic kidney disease (CKD) exhibit an extremely high prevalence of coronary artery disease. Clonal hematopoiesis of indeterminate potential (CHIP) and CKD share pathological features such as aging, chronic inflammation, and accelerated atherosclerosis. Their coexistence can synergistically exacerbate vascular damage and increase coronary risk. However, the association between CHIP and specific coronary lesions in CKD populations has not been reported, and its relationship with cardiovascular events remains controversial. Methods A total of 151 patients with CKD who underwent coronary angiography were prospectively included. To evaluate the status of CHIP, we utilized high-depth targeted sequencing, and measured serum inflammatory factor levels. Furthermore, we systematically followed up these patients to document the occurrence of adverse clinical events. Results CHIP was identified in 65 (43.0%) CKD patients, with the carrier rate steadily rising with age. The CHIP subjects had higher rates of left circumflex (LCx) stenosis, three-vessel disease, and Gensini scores than non-CHIP patients (all P 0.05). After adjusting for relevant clinical risk factors, the presence of CHIP continued to show an independent association with three-vessel disease (OR 2.26, 95% CI 1.07–4.75; P = 0.032). The survival analysis indicated that CHIP, along with non-DNMT3A mutations and a larger clone size (variant allele frequency ≥ 0.10), correlated with the primary composite endpoint (P 0.01). Even after controlling for various clinical variables, the CHIP status still demonstrated an independent association with the primary composite endpoint (HR 2.02, 95% CI 1.11–3.67; P = 0.022). Conclusions CHIP was associated with the severity of coronary lesions and unfavorable clinical outcomes in patients with CKD.
Liu et al. (Thu,) conducted a cohort in Chronic kidney disease (n=151). Clonal hematopoiesis of indeterminate potential (CHIP) vs. Non-CHIP was evaluated on Primary composite endpoint (HR 2.02, 95% CI 1.11-3.67, p=0.022). The presence of clonal hematopoiesis of indeterminate potential in patients with chronic kidney disease was independently associated with an increased risk of adverse clinical events (HR 2.02; 95% CI 1.11-3.67; P=0.022).