{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:13:07Z","timestamp":1793686387376,"version":"4.5.1"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec id=\"ab-hoi250052-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Clonal hematopoiesis of indeterminate potential (CHIP) is the age-related clonal expansion of hematopoietic stem cells with leukemia-associated mutations. Certain CHIP mutations promote atherosclerosis and heart failure through immune-related pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test whether CHIP is associated with the development of myocarditis and pericarditis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This observational population-based cohort study used data from the UK Biobank. Enrollment occurred between 2006 and 2010. Participants with whole-exome sequencing, no prevalent cardiovascular disease or hematological malignancy, and complete covariate data were included. Follow-up occurred for a median of 13.6 (IQR, 12.8-14.2) years. Analyses were conducted from November 2024 to July 2025<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>\n                      Any CHIP (variant allele frequency [VAF] \u22652%) and large CHIP (VAF \u226510%) constituted coprimary study exposures. Secondary analyses considered\n                      <jats:italic>DNMT3A<\/jats:italic>\n                      and\n                      <jats:italic>TET2<\/jats:italic>\n                      CHIP as separate exposures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-8\">\n                    <jats:title>Main outcomes and measures<\/jats:title>\n                    <jats:p>The primary outcome was a composite of incident myocarditis and pericarditis. Cox regression tested associations of CHIP with myocarditis and pericarditis, adjusting for age, sex, race and ancestry, and cardiovascular risk factors. Secondary analyses considered myocarditis and pericarditis as separate outcomes. Additional analyses compared associations of CHIP with myocarditis and pericarditis with those with other cardiovascular diseases, and tested the bidirectional associations between CHIP and noncardiac immune-mediated inflammatory diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 335\u202f426 participants (mean age, 56.1 years; 185\u202f429 female [55.3%] and 149\u202f997 male [44.7%]), 11\u202f057 had any CHIP (3.3%), 7271 had large CHIP (2.2%), and 382 developed myocarditis or pericarditis (0.11%). Any and large CHIP were associated with multivariable-adjusted hazard ratios of 1.75 (95% CI, 1.14-2.68;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01) and 2.07 (95% CI, 1.28-3.33;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003), respectively, for the primary composite outcome of incident myocarditis and pericarditis. Increased risks were observed for\n                      <jats:italic>DNMT3A<\/jats:italic>\n                      and\n                      <jats:italic>TET2<\/jats:italic>\n                      CHIP, with hazard ratios of 2.22 (95% CI, 1.17-4.21;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01) for\n                      <jats:italic>DNMT3A<\/jats:italic>\n                      with pericarditis and 3.65 (95% CI, 1.16-11.49;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03) for\n                      <jats:italic>TET2<\/jats:italic>\n                      with myocarditis. CHIP associated with myocarditis and pericarditis more strongly than with other cardiovascular diseases (eg, coronary artery disease and heart failure). Any CHIP was also associated with 1.27-fold risk (95% CI, 1.16-1.39;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) of developing noncardiac immune-mediated inflammatory diseases, without evidence for reverse causation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi250052-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this study, CHIP was a strong risk factor for myocarditis and pericarditis among middle-aged adults. Targeting CHIP and its downstream pathways may represent a strategy for preventing or treating pericarditis and myocarditis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2025.3369","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T13:30:22Z","timestamp":1756560622000},"page":"1147","source":"Crossref","is-referenced-by-count":23,"title":["Clonal Hematopoiesis and Risk of New-Onset Myocarditis and Pericarditis"],"prefix":"10.1001","volume":"10","author":[{"given":"Art","family":"Schuermans","sequence":"first","affiliation":[{"name":"Broad Institute of Harvard and MIT, Cambridge, Massachusetts"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Boston"},{"name":"Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"},{"name":"Center for Genomic Medicine, Massachusetts General Hospital, 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