CLONAL HEMATOPOIESIS WITH INDETERMINATE POTENTIAL AND RISK OF CORONARY HEART DISEASE
Introduction. The study of clonal hematopoiesis with indeterminate potential (CHIP) and risk of coronary heart disease (CHD) is an actively developing area of research in medicine. CHIP refers to the phenomenon of the emergence of hematopoietic cell clones with uncertain potential for further transformation. Understanding the relationship between this phenomenon and the development of coronary heart disease is important for the identification of new risk factors and the development of effective methods of prevention and treatment of this disease.
Aim. To consider the association between clonal hematopoiesis with indeterminate potential (CHIP) and clonal hematopoiesis (CH) in coronary microvascular dysfunction (CMD) and the potential relationship in the risk of major adverse cardiovascular events based on a literature review.
Research strategy. The literature search was carried out in the following medical research databases: Embase, Scopus and PubMed by keywords. A relevant search yielded 88 articles representing a variety of scientific material on the topic. From this extensive list, 54 articles were selected that meet strictly established inclusion criteria: full-text publications in English, meta-analyses, cohort studies, and statistical methods used. These criteria were set in advance to ensure a high level of evidence and scientific validity of the choice of sources. To further clarify and improve the quality of the selected sources, exclusion criteria were applied: short reports, promotional articles and works in languages outside the linguistic competence of researchers. This stage of selection helped to avoid sources that did not meet the requirements of scientific validity. The depth of the search was 12 years (2007-2023).
Results. Clonal hematopoiesis of indeterminate potential (CHIP) became a subject of research in earlier years, but the main research and discussion on the topic started to be actively developed in the scientific literature in the last decades. With improved genome sequencing and molecular diagnostic techniques, interest in CHIP and its association with various diseases including cardiovascular, cancer and others has increased. It has been suggested that clonal hematopoiesis may be a modifiable risk factor, possibly through the use of cholesterol-lowering drugs or effects on specific inflammatory pathways. Based on our literature review, findings suggest that carriers of clonal hematopoiesis of indeterminate potential (CHIP) found in the elderly have a higher risk of coronary heart disease (CHD) and haematological diseases compared to carriers of these mutations but in the younger generation. The study also links mutations in DNMT3A, TET2, ASXL1 and JAK2 genes with coronary heart disease, noting that carriers of CHIP with these mutations have increased levels of coronary artery calcification, which is a marker of atherosclerotic burden. These findings underscore the significance of CHIP as a risk factor for the development of CHD and haematological diseases, especially in the elderly population.
Conclusions: The presence of clonal hematopoiesis mediates almost one third of the risk of adverse cardiovascular outcomes in coronary artery disease. Further studies are needed to elucidate the role of clonal hematopoiesis of indeterminate potential (CHIP) in increasing the risk of coronary microvascular dysfunction (CMD) and early coronary heart disease (CHD
Tomiris K. Shakhmarova1, https://orcid.org/0009-0008-6884-3908
Madina R. Zhalbinova1, https://orcid.org/0000-0001-9704-8913
Ayaulym E. Chamoieva1, https://orcid.org/0000-0003-0877-3537
Zhanel Z. Mirmanova1, https://orcid.org/0000-0002-0284-3891
Saule E. Rakhimova1, https://orcid.org/0000-0002-8245-2400
Saltanat A. Andosova2, https://orcid.org/0000-0001-7259-183X
Makhabbat S. Bekbosynova2, https://orcid.org/0000-0003-2834-617X
Ainur R. Akilzhanova1, https://orcid.org/0000-0001-6161-8355
1 National Laboratory Astana, Nazarbayev University, Astana, Republic of Kazakhstan;
2 National Research Cardiac Surgery Center, Astana, Republic of Kazakhstan
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Shakhmarova T.K., Zhalbinova M.R., Chamoieva A.E., Mirmanova Zh.Z., Rakhimova S.E., Andosova S.A., Bekbosynova M.S., Akilzhanova A.R. Clonal hematopoiesis with indeterminate potential and risk of coronary heart disease // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 6, pp. 161-170. DOI 10.34689/SH.2023.25.6.019Related publications:
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