Valvular & structural heart diseaseCohort study
Clonal haematopoiesis in patients with degenerative aortic valve stenosis undergoing transcatheter aortic valve implantation
- Cohort study
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 of 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:10.1093/eurheartj/ehz591
Summarised from the published abstract; every number is checked against it