Coronary disease & ACSMeta-analysis
Clonal hematopoiesis, cardiovascular events and treatment benefit in 63,700 individuals from five TIMI randomized trials
- Pooled analysis of five TIMI randomised trials
Authors' conclusion
These results indicate that in clinical trial populations, CHIP is associated with incident but not recurrent coronary events and that the presence of CHIP does not appear to identify patients who will derive greater benefit from commonly used CV therapies.
Study context
- Population
- Patients in five randomised trials of established cardiovascular (CV) therapies (PCSK9, SGLT2, P2Y12, FXa)
- Participants
- 63,700 patients · 5 RCTs
- Comparison
- Clonal hematopoiesis of indeterminate potential (CHIP)+ vs CHIP-
- Outcome
- CV events:
- CV death
- MI
- Ischemic stroke
- Coronary revascularization
- Follow-up
- Median 2.5 years
Pooled result
CV events
Adjusted hazard ratio
1.07
95% CI 0.99–1.16
P = 0.08
CHIP+ vs CHIP-
aHR 1.07 (95% CI 0.99–1.16); P = 0.08
As reported in the abstract
- Patients with ≥1 CV event
- 7,453
Further pooled results
| Outcome | aHR (CI) | P value | |
|---|---|---|---|
| First MI | 1.31 (1.05–1.64) | P = 0.02 | |
| Recurrent MI | 0.94 (0.79–1.13) | ||
| 0.512Adjusted hazard ratio (log scale) |
- Recurrent myocardial infarction (MI): interaction Pint = 0.008 (first vs recurrent MI)
Treatment effect by CHIP status
- No significant heterogeneity in treatment effect between individuals with and without CHIP for any therapy
Original publication
Clonal hematopoiesis, cardiovascular events and treatment benefit in 63,700 individuals from five TIMI randomized trials. Nat Med. Published 6 August 2024. doi:10.1038/s41591-024-03188-z
Summarised from the published abstract; every number is checked against it