Clonal hematopoiesis is associated with adverse events in patients with high-grade carotid artery stenosis.
8 affiliations
- 1Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
- 2Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
- 3Division of Vascular Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
- 4Department of Pathology, Medical University of Vienna, Vienna, Austria.
- 5Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.
- 6Core Facilities, Medical University of Vienna, Vienna, Austria.
- 7Department of Medicine IV, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria.
- 8Department of Laboratory Medicine, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria.
Abstract
Introduction
Clonal hematopoiesis (CH), defined as the expansion of a subset of hematopoietic stem or progenitor cells driven by acquired mutations, represents a novel cardiovascular risk factor. Its role in patients with high-grade carotid stenosis remains to be evaluated.Patients and methods
Next-generation sequencing (NGS) involving 30 genes implicated in CH was used as diagnostic-grade assay (SOPHiA DDM Myeloid Solution) to screen for CH in 83 prospectively collected patients with symptomatic or asymptomatic high-grade carotid stenosis undergoing carotid endarterectomy (CEA).Results
Clonal markers were detected in 16 (19.7 %) of 83 patients (median age 71.2 years), with prevalence increasing at advanced age. At 5-year follow-up, CH carriers showed a higher cumulative incidence of major adverse cardiovascular events (MACE; P = 0.040) compared to patients without CH; all-cause mortality did not differ significantly between groups (P = 0.57). Cox regression revealed a significant association between CH and MACE in a univariable model (P = 0.047), which remained significant after multivariable adjustment for age and sex (P = 0.018). Exploratory analyses suggested that the association between CH and MACE may differ according to carotid stenosis severity, with an increased incidence of MACE observed in patients with <90 % stenosis and concomitant CH, an effect absent in patients with ≥90 % stenosis (P interaction = 0.03).Discussion and conclusions
CH was associated with an adverse 5-year outcome in patients with carotid artery stenosis. These findings identify CH as a hematologic contributor to post-interventional cardiovascular risk and indicate that assessment of CH may offer additional prognostic information for residual risk stratification.
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BibTeX
@article{harkot2026clonal,
title = {{Clonal hematopoiesis is associated with adverse events in patients with high-grade carotid artery stenosis.}},
author = {Olesya Harkot and Roland Jäger and Stephanie Kampf and Michael Gurbisz and Maja Carina Nackenhorst and Johann Wojta and Christian Hengstenberg and Bernhard Haring and Harald Esterbauer and Christoph Neumayer and Stefan Stojkovic and Svitlana Demyanets},
journal = {Atherosclerosis plus},
year = {2026},
month = oct,
doi = {10.1016/j.athplu.2026.100617},
url = {https://europepmc.org/article/MED/42898635},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clonal hematopoiesis is associated with adverse events in patients with high-grade carotid artery stenosis.
AU - Olesya Harkot
AU - Roland Jäger
AU - Stephanie Kampf
AU - Michael Gurbisz
AU - Maja Carina Nackenhorst
AU - Johann Wojta
AU - Christian Hengstenberg
AU - Bernhard Haring
AU - Harald Esterbauer
AU - Christoph Neumayer
AU - Stefan Stojkovic
AU - Svitlana Demyanets
PY - 2026
DA - 2026/10/01
JO - Atherosclerosis plus
DO - 10.1016/j.athplu.2026.100617
UR - https://europepmc.org/article/MED/42898635
AB - Introduction Clonal hematopoiesis (CH), defined as the expansion of a subset of hematopoietic stem or progenitor cells driven by acquired mutations, represents a novel cardiovascular risk factor. Its role in patients with high-grade carotid stenosis remains to be evaluated.Patients and methods Next-generation sequencing (NGS) involving 30 genes implicated in CH was used as diagnostic-grade assay (SOPHiA DDM Myeloid Solution) to screen for CH in 83 prospectively collected patients with symptomatic or asymptomatic high-grade carotid stenosis undergoing carotid endarterectomy (CEA).Results Clonal markers were detected in 16 (19.7 %) of 83 patients (median age 71.2 years), with prevalence increasing at advanced age. At 5-year follow-up, CH carriers showed a higher cumulative incidence of major adverse cardiovascular events (MACE; P = 0.040) compared to patients without CH; all-cause mortality did not differ significantly between groups (P = 0.57). Cox regression revealed a significant association between CH and MACE in a univariable model (P = 0.047), which remained significant after multivariable adjustment for age and sex (P = 0.018). Exploratory analyses suggested that the association between CH and MACE may differ according to carotid stenosis severity, with an increased incidence of MACE observed in patients with <90 % stenosis and concomitant CH, an effect absent in patients with ≥90 % stenosis (P interaction = 0.03).Discussion and conclusions CH was associated with an adverse 5-year outcome in patients with carotid artery stenosis. These findings identify CH as a hematologic contributor to post-interventional cardiovascular risk and indicate that assessment of CH may offer additional prognostic information for residual risk stratification.
SN - 2667-0909
SN - 2667-0895
ER -