{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:29:21Z","timestamp":1790980161245,"version":"4.1.0"},"reference-count":11,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Clonal hematopoiesis (CH) with acquired pathogenic variants in myeloid leukemia driver genes is common in older adults but of unknown prognostic value.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the prevalence of CH and the utility of the CH risk score (CHRS) in estimating all-cause and disease-specific mortality in older adults with CH.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based prospective cohort study involved community-dwelling older adults (aged 67-90 years) without hematologic malignant neoplasms (HMs) who were participants in the Atherosclerosis Risk in Communities Visit 5 at 4 US centers: Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; and Washington County, Maryland. Samples were collected from 2011 to 2013, sequencing was performed in 2022, and data analysis was completed in 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n The exposure was a diagnosis of CH. CHRS scores (calculated using 8 demographic, complete blood cell count, and molecular factors) were used to categorize individuals with CH into low-risk (CHRS \u22649.5), intermediate-risk (CHRS &amp;gt;9.5 to &amp;lt;12.5), and high-risk (CHRS \u226512.5) groups.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was all-cause mortality, and secondary outcomes were HM mortality, cardiovascular disease mortality, and death from other causes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 3871 participants without a history of HM (mean [SD] age, 75.7\u2009[5.2] years; 2264 [58.5%] female individuals; 895 [23.1%] Black individuals; 2976 White individuals [76.9%]), 938 (24.2%) had CH. According to the CHRS, 562 (59.9%) were low risk, 318 (33.9%) were intermediate risk, and 58 (6.2%) were high risk. During a median (IQR) follow-up of 7.13 (5.63-7.78) years, 570 participants without CH (19.4%) and 254 participants with CH (27.1%) died. Mortality by CHRS risk group was 128 deaths (22.8%) for low risk, 93 (29.2%) for intermediate risk, and 33 (56.9%) for high risk. By use of multivariable competing risk regression, subdistribution hazard ratios (sHRs) for all-cause mortality were 1.08 (95% CI, 0.89-1.31;\n P<\/jats:italic>\n \u2009=\u2009.42) for low-risk CH, 1.12 (95% CI, 0.89-1.41;\n P<\/jats:italic>\n \u2009=\u2009.31) for intermediate-risk CH, and 2.52 (95% CI, 1.72-3.70;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) for high-risk CH compared with no CH. Among individuals in the high-risk CH group, the sHR of death from HM (6 deaths [10.3%]) was 25.58 (95% CI, 7.55-86.71;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and that of cardiovascular death (12 deaths [20.7%]) was 2.91 (95% CI, 1.55-5.47;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, the CHRS was associated with all-cause, HM-related, and cardiovascular disease mortality in older adults with CH and may be useful in shared decision-making to guide clinical management and identify appropriate candidates for clinical trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.51927","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T12:50:51Z","timestamp":1705495851000},"page":"e2351927","source":"Crossref","is-referenced-by-count":46,"title":["Clonal Hematopoiesis Risk Score and All-Cause and Cardiovascular Mortality in Older Adults"],"prefix":"10.1001","volume":"7","author":[{"given":"Seyedmohammad","family":"Saadatagah","sequence":"first","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas"},{"name":"Center for Translational Research on Inflammatory Diseases, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Mesbah","family":"Uddin","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"Broad Institute of MIT and Harvard, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachelle D.","family":"Weeks","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Center for Prevention of Progression, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Niroula","sequence":"additional","affiliation":[{"name":"Broad Institute of MIT and Harvard, Cambridge, Massachusetts"},{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Department of Laboratory Medicine, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Ru","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Gondek","sequence":"additional","affiliation":[{"name":"Department of Oncology, Johns Hopkins University, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Bick","sequence":"additional","affiliation":[{"name":"Division of Genetic Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin L.","family":"Ebert","sequence":"additional","affiliation":[{"name":"Broad Institute of MIT and Harvard, Cambridge, Massachusetts"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Center for Prevention of Progression, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Howard Hughes Medical Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Platz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Department of Oncology, Johns Hopkins University, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"Broad Institute of MIT and Harvard, Cambridge, Massachusetts"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"issue":"5","key":"zoi231522r1","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1182\/blood-2017-07-746453","article-title":"Age-related clonal hematopoiesis.","volume":"131","author":"Shlush","year":"2018","journal-title":"Blood"},{"issue":"7","key":"zoi231522r2","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid 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