Association of clonal haematopoiesis with heart failure incidence and outcomes: A systematic review and meta-analysis.
Summary
This systematic review and meta-analysis (n=57,755) shows clonal haematopoiesis increases the risk of incident heart failure (HR 1.23, 95% CI 1.12–1.35) and is associated with worse outcomes among those with HF.
Key Findings
- Across 57,755 participants, clonal haematopoiesis was associated with higher incident HF risk (HR 1.23, 95% CI 1.12–1.35).
- CH was also linked with poorer prognosis among individuals with established HF.
- Triple-independent selection and three-level mixed-effects meta-analyses enhanced methodological rigor.
Clinical Implications
Consider integrating CH status into HF risk assessment and trial stratification; it may help identify high-risk individuals for intensified surveillance or targeted anti-inflammatory pathways pending interventional validation.
Why It Matters
By consolidating heterogeneous evidence with robust methods, this work strengthens the genomic-inflammatory paradigm of HF risk and prognosis, informing risk stratification and future mechanistic and interventional research.
Limitations
- Predominantly observational evidence with potential residual confounding and variable CH definitions.
- Heterogeneity in cohorts, sequencing depth, clone thresholds, and outcome adjudication.
Future Directions
Prospective studies linking CH clone characteristics (gene, VAF, dynamics) to HF subtypes and interventional trials targeting inflammatory pathways in CH-positive individuals.
Study Information
- Study Type
- Systematic Review/Meta-analysis
- Research Domain
- Prognosis
- Evidence Level
- II - Systematic review and meta-analysis predominantly of observational studies with rigorous methodology.
- Study Design
- OTHER