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. Author manuscript; available in PMC: 2020 Jul 30.
Published in final edited form as: J Am Coll Cardiol. 2019 Jul 30;74(4):567–577. doi: 10.1016/j.jacc.2019.06.007

Central Illustration: Clonal hematopoiesis: a potent newly recognized risk factor for atherothrombosis and adverse heart failure outcomes.

Central Illustration:

A mutation in a hematopoietic stem cell in the bone marrow confers a proliferative advantage that yields a clone of mutant leukocytes (top panel) that appear in peripheral blood (middle panel). The presence of these clones in blood associates with a heightened risk of atherothrombotic events and with worsened outcomes in patients predisposed to ischemic cardiomyopathy (lower panel, left). Individuals with CHIP transition to acute leukemia only at an annual rate of 0.5-1% (lower panel, left) Thus, for an individual, CHIP may entail a greater risk of cardiovascular events than for cancer.