Impact of Carrying DNMT3A or TET2 Mutations on Plaque Characteristics and Prognosis in Patients With STEMI Based on OCT
Authors' conclusion
Patients with ST-segment-elevation myocardial infarction and DNMT3A/TET2 mutations exhibit vulnerable characteristics in their coronary plaques, along with an increased risk of experiencing major adverse cardiovascular events. Moreover, carrying TET2 mutations confers a worse prognosis compared with solely having DNMT3A mutations.
Study context
- Population
- Patients with ST-segment-elevation myocardial infarction undergoing routine optical coherence tomography, May 2017-May 201912.3% carriers of DNMT3A or TET2 gene mutations
- Participants
- 628 patients
- Comparison
- Carriers of DNMT3A or TET2 mutations vs non-carriers
- Outcome
- Major adverse cardiovascular events:
- All-cause death
- Nonfatal myocardial infarction
- Nonfatal stroke
- Revascularization due to clinical ischemic events
- Follow-up
- Median 2.4 years (interquartile range 2.0-3.0)
Methodological detailstargeted deep exome sequencing of peripheral blood (custom panel targeting DNMT3A and TET2), variant allele frequency ≥2%
- Targeted deep exome sequencing of peripheral blood (custom panel targeting DNMT3A and TET2)
- Variant allele frequency ≥2%
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
DNMT3A/TET2 mutations
1.91(1.19–3.07)
P = 0.008TET2 mutations
3.57(1.78–7.17)
P < 0.001Further findings
Age · older with mutations
P < 0.001
Hypertension, diabetes, dyslipidemia prevalence
Hypertension
Diabetes
Dyslipidemia
Hypertension, diabetes, dyslipidemia prevalence
- Comparable prevalence rates
Plaque vulnerability on optical coherence tomography
- Carriers: higher macrophage proportion, smaller minimal lumen area, thinner fibrous cap, and higher lipid index
Original publication
Impact of Carrying DNMT3A or TET2 Mutations on Plaque Characteristics and Prognosis in Patients With STEMI Based on OCT. Circ Cardiovasc Imaging. Published 4 August 2025. doi:10.
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