About one in five patients with cancer who undergo genetic testing are incidentally found to have mutations in their blood called clonal hematopoiesis of indeterminate potential (CHIP).
A study by Vanderbilt Health researchers reveals that it puts them at increased risk for heart disease following cancer treatment.
The findings, published in JAMA Oncology, support the potential benefits of screening patients for CHIP before they undergo cancer treatment so they can be more closely monitored for heart complications. CHIP is a condition, not a disease, characterized by age-related variants in blood stem cells, and it is typically asymptomatic.
The researchers used Vanderbilt Health’s biorepository, BioVU, to link electronic health records with whole-genome sequencing data. They compared cardiovascular health outcomes in patients with and without CHIP.
All patients had been diagnosed with solid tumors and had no prior heart failure, ischemic heart disease, or arrhythmia.
Over 10 years, those with CHIP had a higher incidence of heart failure (20.3% vs. 14.5%) and ischemic cardiovascular disease (25.3% vs. 18.5%), especially among those receiving intensive chemotherapy.
“We frequently find CHIP in patients with cancer, but previously we did not consider this to be an important result for their care,” said Dr. Alexander Bick. “We now know that these patients are at higher risk of heart disease and would likely benefit from including cardiologists in their care team.”
The patients underwent chemotherapy, radiotherapy, immunotherapy, or combination treatments. Cardiovascular disease is the leading cause of noncancer deaths among cancer survivors.
The study analyzed data from 8,004 patients, identifying 549 with CHIP. Most CHIP patients were male (54% vs. 45%) and had hypertension (78% vs. 69%) compared to those without CHIP.
This study, the largest to date on CHIP and cardiovascular risk after cancer treatment, suggests that testing for CHIP before cancer therapy may help stratify risk and guide monitoring and care strategies.
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