About one in five cancer patients undergoing genetic testing are incidentally found to have blood mutations known as clonal hematopoiesis of indeterminate potential (CHIP). A study conducted by scientists at Vanderbilt Health shows that this condition increases the risk of developing cardiovascular disease after cancer treatment.

The study results, published in JAMA Oncology, highlight the potential benefit of screening patients for CHIP before starting cancer therapy, allowing for closer cardiac monitoring and prevention of complications. CHIP is a condition rather than a disease; it reflects age-related changes in blood stem cells and is usually asymptomatic.

Researchers identified which patients had CHIP by using Vanderbilt Health’s BioVU biorepository to link electronic health records with whole-genome sequencing data. They compared cardiovascular outcomes in patients with CHIP to those in patients without the condition.

All patients had been diagnosed with solid tumors, and none had heart failure, coronary artery disease, or arrhythmias prior to cancer treatment.

Over the 10 years following treatment, patients with CHIP had significantly higher rates of heart failure (20.3% vs. 14.5%) and coronary artery disease (25.3% vs. 18.5%). This effect was more pronounced in patients who received more intensive chemotherapy.

“We often detect CHIP in cancer patients, but previously we did not consider it an important finding for their treatment,” said lead study author Alexander Bick. “Now we know that these patients are at higher risk of cardiovascular disease and would likely benefit from having cardiologists included in their care team.”

Patients received chemotherapy, radiation therapy, immunotherapy, or combinations of these treatments. Cardiovascular disease is the leading cause of non-cancer-related death among cancer survivors.

The researchers analyzed data from 8,004 patients, 549 of whom were found to have CHIP. To their knowledge, this is the largest study to date evaluating the association between CHIP and cardiovascular disease in patients with solid tumors undergoing cancer treatment. Most patients with CHIP were male (54% vs. 45%) and had hypertension (78% vs. 69%) compared with patients without the condition.

The clinical implications of the study suggest that testing patients for CHIP before initiating cancer therapy may be useful for risk stratification and individualized cardiovascular monitoring, as well as for providing early cardio-oncology consultations and considering cardioprotective strategies.