ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Impact of clonal hematopoiesis of indeterminate potential on prognosis in patients with severe aortic valve stenosis: a meta-analysis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClonal hematopoiesis of indeterminate potential (CHIP), commonly involving TET2 and DNMT3A mutations, is increasingly recognized as a cardiovascular risk factor, but its prognostic role in severe aortic valve stenosis (AVS) remains unclear. This study aimed to systematically evaluate the impact of CHIP on survival in AVS patients undergoing valve replacement.
methodsA systematic search of PubMed, Embase, Web of Science, and Scopus through May 2025 identified observational studies of CHIP in AVS patients undergoing valve replacement. Eligible studies used validated genomic sequencing methods to identify CHIP and reported mortality outcomes. Two reviewers independently extracted study characteristics, outcomes, and related variables. Pooled hazard ratios (HRs) were calculated, with subgroup analyses by mutation type and geographic region, and meta-regression to assess effect modifiers. Risk of bias was assessed using the Newcastle-Ottawa Scale, and sensitivity and publication bias analyses were also assessed.
resultsFive studies with 1,175 patients were included. CHIP showed a non-significant trend toward increased all-cause mortality (HR = 1.58; 95% CI: 0.97-2.57; P = 0.0687; I
conclusionsCHIP, particularly TET2-related mutations, is associated with poorer survival in patients with severe AVS undergoing valve replacement. In Western populations, CHIP was significantly associated with increased mortality. Higher BMI further strengthened this association across all patients. These findings indicate that CHIP may be a potential marker for risk stratification and preventive strategies, but confirmation in larger and more diverse cohorts is required.
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