Clonal hematopoiesis of indeterminate potential is not associated with increased risk of cardiovascular events in systemic lupus erythematosus patients

By Samar Mahmoud, MS
Published February 28, 2022

Key Takeaways

  • This study found that the incidence of clonal hematopoiesis of indeterminate potential (CHIP) was high in systemic lupus erythematosus (SLE) patients with respect to age. 

  • Incidence of CHIP in SLE patients was not associated with heightened risk of cardiovascular events (CVE).

Cardiovascular disease (CVD) remains a leading cause of mortality in SLE patients. A major contributor to CVD mortality in SLE patients is accelerated atherosclerosis, which is not well explained by traditional cardiovascular risk factors.

Why This Study Matters 

CHIP correlates with age and is found in asymptomatic adults with a normal blood count. In the general population, CHIP was found to be associated with CVE. However, the prevalence of CHIP in SLE patients is unknown. To address this need, this study sought to evaluate the incidence of CHIP in SLE patients and to determine if CHIP was associated with CVE. 

Study Design 

This study is a supplementary analysis of the PLUS study, a randomized, double-blind, placebo-controlled, multicenter trial conducted from June 2007 through August 2010. Investigators used high-throughput sequencing of 53 genes implicated in clonal hematopoiesis to search for somatic mutations on collected genomic DNA. The prevalence of CHIP was evaluated in 438 SLE patients free of hematological malignancy. The primary outcome of the study was the incidence of CVE in SLE. 

Results and Conclusions

Investigators identified 63 somatic mutations in 47 patients, with an overall CHIP prevalence of 10.7% in SLE patients. The majority of SLE patients (78.7%) carried a single mutation. CHIP was associated with age, age at SLE diagnosis, and a lower frequency of antiphospholipid antibodies. CHIP in SLE patients occurred more than 20 years earlier than in control patients. The presence of CHIP at the beginning of the study was not linked to the incidence of CVE during the follow-up period. 

Related Research

Consider these findings from similar research studies:

  • In postmenopausal women free of cancer and cardiovascular disease, a normal body mass index was strongly associated with a lower incidence of CHIP (Source). 

  • The presence of CHIP in peripheral-blood cells is associated with increased risk of coronary heart disease in humans and with accelerated atherosclerosis in mice (Source).

Original Source 

David C, Duployez N, Eloy P, et al. Clonal hematopoiesis of indeterminate potential and cardiovascular events in systemic lupus erythematosus (HEMATOPLUS study). Rheumatology. Published online February 17, 2022:keac108.

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