{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:37:55Z","timestamp":1790804275252,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardiac surgery triggers sterile innate immune responses leading to postoperative complications. Clonal hematopoiesis (CH) is associated with short\u2010term inflammation\u2010mediated outcomes after cardiac surgery. The impact of CH on long\u2010term postoperative outcomes remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In this cohort study, patients undergoing elective cardiac surgery were included from January 2017 to September 2019. Patients were screened for CH using a predefined gene panel of 19 genes. Recorded clinical events were all\u2010cause death, major adverse cardiac and cerebral events including cardiovascular death, myocardial infarction or nonscheduled coronary revascularization, stroke, and hospitalization for acute heart failure. The primary study outcome was time to a composite criterion including all\u2010cause mortality and major adverse cardiac and cerebral events. Among 314 genotyped patients (median age: 67\u2009years; interquartile range 59\u201374\u2009years), 139 (44%) presented with CH, based on a variant allelic frequency \u22651%. Carriers of CH had a higher proportion of patients with a history of atrial fibrillation (26% for CH versus 17% for non\u2010CH carriers,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.022). The most frequently mutated genes were\n                      <jats:italic toggle=\"no\">DNMT3A<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"no\">TET2<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"no\">ASXL1<\/jats:italic>\n                      . After a median follow\u2010up of 1203 [813\u20131435] days, the primary outcome occurred in 50 patients. After multivariable adjustment, CH was independently associated with a higher risk for the primary outcome (hazard ratio, 1.88 [95% CI, 1.05\u20133.41],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.035). Most adverse events occurred in patients carrying\n                      <jats:italic toggle=\"no\">TET2<\/jats:italic>\n                      variants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients undergoing cardiac surgery, CH is frequent and associated with a 2\u2010fold increased long\u2010term risk for major adverse clinical outcomes. CH is a novel risk factor for long\u2010term postcardiac surgery complications and might be useful to personalize management decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT03376165.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.034255","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T06:30:47Z","timestamp":1724913047000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Clonal Hematopoiesis Is Associated With Long\u2010Term Adverse Outcomes Following Cardiac Surgery"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-6098","authenticated-orcid":false,"given":"Sandro","family":"Ninni","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]},{"name":"Montreal Heart Institute and Universit\u00e9 de Montr\u00e9al","place":["Montreal, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Vicario","sequence":"additional","affiliation":[{"name":"Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Coisne","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9913-9023","authenticated-orcid":false,"given":"Eloise","family":"Woitrain","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amine","family":"Tazibet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5070-4810","authenticated-orcid":false,"given":"Caitlin M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7079-8914","authenticated-orcid":false,"suffix":"Jr","given":"Luis A.","family":"Diaz","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9179","authenticated-orcid":false,"given":"James Robert","family":"White","sequence":"additional","affiliation":[{"name":"Resphera Biosciences","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Koussa","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Dubrulle","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5586-539X","authenticated-orcid":false,"given":"Francis","family":"Juthier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Jungling","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Vincentelli","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011\u2010EGID","place":["Lille, 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