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Master Thesis

Frequency of clonal hematopoiesis of indeterminate potential in patients over 75 years with a first cardiovascular event. Consequences on inflammation and atherosclerosis

Abstract : Context: clonal hematopoiesis of indeterminate potential (CHIP) has been described for several years as being common in the general population, and to be associated with an increased risk of cardiovascular disease. Experimental data tend to show that the link between CHIP and atherosclerosis or heart failure is mainly mediated by inflammation. To date, little data is available in human. Goals. Our study aimed to assess the prevalence of CHIP in patients over 75 years of age with a first myocardial infarction, as well as the links between CHIP and inflammation and atherosclerosis. The interaction with risk factors and the influence on patient prognosis were also studied. Methods: we conducted a prospective, single-center study, including patients aged at least 75 years with a first myocardial infarction. The patients were included 2 to 7 months after the event, and had a blood test allowing DNA sequencing in search for CHIP and the dosing of high-sensitive CRP, a supra-aortic trunks ultrasonography with 3D quantification of atherosclerotic volume, and TTE. Recurrence of a cardiovascular event was also sought. Results: of the 106 included patients, 54% were carriers of CHIP. CHIP carriers had a higher level of inflammation and a modestly higher atheroma load than patients without CHIP. These differences seemed to be particularly correlated with the size of the clone and the presence of a mutation in the DNMT3A and/or TET2 genes. Patients with CHIP had on average fewer cardiovascular risk factors, but had an increased risk of cardiovascular event after the myocardial infarction, in particular hospitalization for heart failure. Conclusion: this study shows that the prevalence of CHIP in elderly patients with myocardial infarction is high, and support a pro-inflammatory role of CHIP and altered prognosis. Links with atheroma and risk factors will need to be reassessed in future works.
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https://dumas.ccsd.cnrs.fr/dumas-03604331
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Submitted on : Thursday, March 10, 2022 - 1:30:25 PM
Last modification on : Saturday, March 12, 2022 - 3:32:42 AM

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Sami Fawaz. Frequency of clonal hematopoiesis of indeterminate potential in patients over 75 years with a first cardiovascular event. Consequences on inflammation and atherosclerosis. Life Sciences [q-bio]. 2021. ⟨dumas-03604331⟩

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