Researchers of a study investigating the role of clonal hematopoiesis of indeterminate potential (CHIP) in cardiovascular disease (CVD) among patients with multiple myeloma (MM) undergoing hematopoietic stem cell transplant (HCT) found CHIP to be highly prevalent and significantly associated with increased CVD risk. Among 1,036 patients with MM, 19.4% had at least one CHIP variant, and the 5-year incidence of CVD was 21.1% in these individuals, compared to 8.4% in those without CHIP. The risk was particularly elevated in patients with CHIP who also had hypertension or dyslipidemia, with a nearly 7-fold and 4-fold increased CVD risk, respectively. The findings highlight CHIP as a potential biomarker for CVD risk in patients with MM undergoing HCT.

CHIP variants, especially in genes like ASXL1, were strongly associated with adverse cardiovascular outcomes, including heart failure, coronary artery disease, and stroke. The study also found a dose-dependent relationship between the number of CHIP mutations and CVD risk. Given the lack of CHIP-targeted interventions, the study underscores the importance of managing modifiable risk factors such as hypertension and dyslipidemia in CHIP-positive patients. Personalized approaches, including intensive cardiovascular monitoring and proactive treatment strategies, may help mitigate the elevated CVD risks associated with CHIP in this high-risk population.

Reference: Rhee JW, Pillai R, He T, et al. Clonal Hematopoiesis and Cardiovascular Disease in Patients With Multiple Myeloma Undergoing Hematopoietic Cell Transplant. JAMA Cardiol. 2024;9(1):16-24. doi: 10.1001/jamacardio.2023.4105.