{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:47:04Z","timestamp":1784209624088,"version":"3.55.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Allogeneic hematopoietic stem cell transplantation (alloHSCT) has been associated with serious cardiotoxicity, including atrial fibrillation (AF) and other cardiac events. In preclinical models, posttransplant clonal hematopoiesis (CH) frequently parallels or precedes clinical AF, yet whether this is seen in patients or has implications for cardiotoxic risk in long\u2010term follow\u2010up is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Leveraging consecutive patients treated with alloHSCT, genotyped using deep\u2010amplicon sequencing to detect the presence of CH, we assessed the development of new (incident) AF, by CH status. Secondary outcomes were the occurrence of major adverse cardiac events, defined as heart failure, myocardial infarction, AF, symptomatic ventricular arrhythmias, and cardiovascular death after alloHSCT. We also assessed the relation between CH and post\u2010alloHSCT cancer survival outcomes. Observed incident AF rates were compared with Framingham heart predicted rates. Multivariable regression and survival analyses were used to define the relation between CH and incident AF, major adverse cardiac events, progression\u2010free survival, and overall survival. We also explored these relationship by specific mutation and by varying variant allele frequency.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Overall, 201 patients with deep sequencing after alloHSCT were identified (median age, 59\u2009years; 46.3% with hypertension; and 42.3% with CH, including 29.5% with \u22652 mutations). Over a median follow\u2010up of 35\u2009months, 11.5% of patients developed incident AF, and 29.9% experienced major adverse cardiac events. In those without prior AF, the weighted\u2010average incidence was 407 per 10\u2009000 person\u2010years compared with the Framingham\u2010predicted 63 per 10\u2009000 person\u2010years (risk ratio, 6.4;\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001; absolute excess risk, 344). In follow\u2010up, increased CH burden was associated with higher risk of incident AF (hazard ratio [HR], 4.0 [95% CI, 1.2\u201314.1];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.03), cancer\u2010progression (HR, 2.6 [95% CI, 1.3\u20135.2];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.006), and death (HR, 2.1 [95% CI, 1.0\u20134.3];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.047). There was no difference in non\u2010AF major adverse cardiac events.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Collectively, these data suggest among patients treated with alloHSCT, the presence of CH appears to portend increased AF risk, though validation in larger prospective studies is needed.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039977","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:05:16Z","timestamp":1758279916000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Presence of Clonal Hematopoiesis and Cardiac Events After Allogeneic Stem Cell Transplantation"],"prefix":"10.1161","volume":"14","author":[{"given":"Cooper","family":"Quartermaine","sequence":"first","affiliation":[{"name":"The Ohio State University Medical Center","place":["Columbus, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2517-9943","authenticated-orcid":false,"given":"Zach","family":"Braunstein","sequence":"additional","affiliation":[{"name":"James Cancer Hospital and Solove Research Institute at The Ohio State University","place":["Columbus, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-7297","authenticated-orcid":false,"given":"Adnan","family":"Shaaban","sequence":"additional","affiliation":[{"name":"The Ohio State University Medical Center","place":["Columbus, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma","family":"Habib","sequence":"additional","affiliation":[{"name":"James Cancer Hospital and Solove Research Institute at The Ohio State University","place":["Columbus, 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