Cohort study
Hematopoietic Somatic Mosaicism Is Associated With an Increased Risk of Postoperative Atrial Fibrillation
- Prospective cohort study
Authors' conclusion
HSM is frequent in candidates for AVR, is associated with an enrichment of proinflammatory cardiac monocyte-derived macrophages, and predisposes to a higher incidence of POAF.
Study context
- Population
- Patients referred for surgical aortic valve replacement (AVR)
- Participants
- 104 patients
- Exposure
- Hematopoietic somatic mosaicism (HSM) carriers vs non-carriers
Main finding
As reported in the abstract
Prevalence of HSM
HSM prevalence, conventional panel (97 genes), variant allelic frequencies ≥2%
29%
HSM prevalence, full HemePACT panel, variant allelic frequencies ≥1%
60%
Observational data: associations, not effects.
Further findings
| Outcome | age-adjusted OR (95% CI) | P value | |
|---|---|---|---|
| POAF · most inclusive HSM definition | 3.5 (1.52–8.03) | P = 0.003 | |
| 0.10.31310Age-adjusted or (log scale) |
Postoperative atrial fibrillation (POAF)
- Three of 4 HSM definitions significantly associated with higher POAF risk
Inflammatory response and myeloid cells
- HSM carriers: exaggerated inflammatory response after AVR; higher activated CD64+CD14+CD16- circulating monocytes and inflammatory monocyte-derived macrophages in presurgery myocardium
Original publication
Hematopoietic Somatic Mosaicism Is Associated With an Increased Risk of Postoperative Atrial Fibrillation. J Am Coll Cardiol. Published 4 April 2023. doi:10.1016/j.jacc.2023.01.036
Summarised from the published abstract; every number is checked against it