Cardiovascular disease (CVD) is the leading cause of non-cancer death among cancer survivors, and chemotherapy and immunotherapy increase this risk. Clonal hematopoiesis of indeterminate potential (CHIP), an age-related phenomenon, independently increases the risk of CVD when somatic mutations in pre-leukemic genes are present in 4% or more of peripheral blood nucleated cells. Since patients with solid tumors exhibit a higher prevalence of CHIP compared to age-matched controls,Understanding whether CHIP amplifies treatment-related cardiovascular toxicity has direct clinical implications for risk stratification and monitoring strategies in cancer survivors. We hypothesize that CHIP is associated with an increased risk of cardiovascular disease in patients receiving cardiotoxic cancer treatments. Since cumulative exposure to cancer treatment is an important determinant of cardiotoxicity, we further hypothesize that CHIP may amplify this risk, with more pronounced effects in individuals with higher cumulative chemotherapy exposure.

To more accurately assess the relationship between CHIP and cardiovascular events, the study used propensity score matching to balance differences in baseline characteristics, such as age, sex, and underlying conditions, between patients with and without CHIP. The results showed that in the matched cohort, patients with CHIP had a significantly higher cumulative incidence of heart failure within 10 years of treatment (20.3% vs. 14.5%), and the incidence of ischemic cardiovascular disease was also noticeably higher (25.3% vs. 18.5%). In multivariable analyses adjusted for demographic and clinical factors, CHIP remained independently associated with an increased risk of heart failure.

Reference Information：

https://jamanetwork.com/journals/jamaoncology/fullarticle/2843268