Valvular & structural heart disease
Clonal haematopoiesis in patients with degenerative aortic valve stenosis undergoing transcatheter aortic valve implantation
Authors' conclusion
This is the first study to show that acquired somatic mutations in the most commonly mutated CHIP-driver genes occur frequently in patients with severe degenerative AV stenosis, are associated with increased pro-inflammatory leucocyte subsets, and confer a profound increase in mortality following successful TAVI.
Study context
- Population
- Patients with severe degenerative aortic valve (AV) stenosis undergoing transfemoral aortic valve implantation (TAVI)
- Participants
- 279 patients
- Exposure
- DNMT3A- or TET2-CHIP-driver mutation carriers vs non-carriers
- Clonal haematopoiesis of indeterminate potential (CHIP)n = 93
- Outcome
- Incidence of CHIP (DNMT3A or TET2 mutations)
Main finding
As reported in the abstract
DNMT3A- or TET2-CHIP-driver mutations (VAF ≥ 2%)
CHIP
33.3%
93
- Incidence 55-69 years
- 25%
- Incidence 90-100 years
- 52.9%
Observational data: associations, not effects.
Further findings
Clinical parameters, atherosclerotic disease, blood cell counts, inflammatory markers, procedural characteristics
- No difference between carriers and non-carriers
Medium-term all-cause mortality after successful TAVI
- Profoundly increased in CHIP carriers
Leucocyte subsets
- Pro-inflammatory T-cell polarization in DNMT3A carriers; increased non-classical monocytes in TET2 carriers
Original publication
Clonal haematopoiesis in patients with degenerative aortic valve stenosis undergoing transcatheter aortic valve implantation. Eur Heart J. Published 3 September 2019. doi:10.
Summarised from the published abstract; every number is checked against it