Cardio-oncology & otherCohort study
Clonal Hematopoiesis and Cardiovascular Disease in Patients With Multiple Myeloma Undergoing Hematopoietic Cell Transplant
- Retrospective cohort study
- single-centre
Authors' conclusion
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.
Study context
- Population
- Patients with multiple myeloma undergoing first autologous hematopoietic cell transplant (HCT), City of Hope, 2010–2016
- Participants
- 1,036 patients
- Exposure
- Clonal hematopoiesis of indeterminate potential (CHIP) vs no CHIP
- CHIPn = 201
- Outcome
- Cumulative incidence and risk of de novo CVD (HF, CAD or stroke) after HCT
- Follow-up
- 5 years
Main finding
CVD
Hazard ratio
2.72
95% CI 1.70–4.39
P < 0.001
By group
CHIP vs No CHIP
HR 2.72 (95% CI 1.70–4.39); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | |
|---|---|---|---|
| Individual CVD outcomes — CHIP vs No CHIP · HF · multivariable model | 4.02 (2.32–6.98) | ||
| Individual CVD outcomes — CHIP vs No CHIP · CAD · multivariable model | 2.22 (1.06–4.63) | ||
| Individual CVD outcomes — CHIP vs No CHIP · stroke · multivariable model | 3.02 (1.07–8.52) | ||
| 0.10.31310Hazard ratio (log scale) |
| Outcome | Values | Estimate |
|---|---|---|
| CVD, ≥2 CHIP variants · 5 years | ≥2 variants 25.6% |
Cardiovascular disease (CVD) with CHIP plus preexisting hypertension or dyslipidemia
- CHIP + hypertension: nearly 7-fold increased risk; CHIP + dyslipidemia: 4-fold (reference: no CHIP, no hypertension, or dyslipidemia)
Original publication
Clonal Hematopoiesis and Cardiovascular Disease in Patients With Multiple Myeloma Undergoing Hematopoietic Cell Transplant. JAMA Cardiol. Published 1 January 2024. doi:10.1001/jamacardio.2023.4105
Summarised from the published abstract; every number is checked against it