{"id":1780,"date":"2024-02-19T16:56:27","date_gmt":"2024-02-19T07:56:27","guid":{"rendered":"http:\/\/newdev.nobomedicine.com\/?post_type=publication&#038;p=1780"},"modified":"2024-04-08T09:09:34","modified_gmt":"2024-04-08T00:09:34","slug":"clonal-hematopoiesis-and-acute-ischemic-stroke-outcomes","status":"publish","type":"publication","link":"https:\/\/www.nobomedicine.com\/?publication=clonal-hematopoiesis-and-acute-ischemic-stroke-outcomes","title":{"rendered":"Clonal Hematopoiesis and Acute Ischemic Stroke Outcomes"},"content":{"rendered":"\n<p><strong>Objective:&nbsp;<\/strong>The effect of clonal hematopoiesis of indeterminate potential (CHIP) on the manifestation and clinical outcomes of acute ischemic stroke (AIS) has not been fully elucidated.<\/p>\n\n\n\n<p><strong>Methods:&nbsp;<\/strong>Patients with AIS were included from a prospective registry coupled with a DNA repository. Targeted next-generation sequencing on 25 genes that are frequently mutated in hematologic neoplasms was performed. The prevalence of CHIP was compared between patients with AIS and age-matched healthy individuals. A multivariate linear or logistic regression model was used to assess the association among CHIP and stroke severity, hemorrhagic transformation, and functional outcome at 90 days.<\/p>\n\n\n\n<p><strong>Results:&nbsp;<\/strong>In total, 380 patients with AIS (mean age = 67.2 \u00b1 12.7 years; 41.3% women) and 446 age-matched controls (mean age = 67.2 \u00b1 8.7 years; 31.4% women) were analyzed. The prevalence of CHIP was significantly higher in patients with AIS than in the healthy controls (29.0 vs 22.0%, with variant allele frequencies of 1.5%, p = 0.024). PPM1D was found to be most significantly associated with incident AIS (adjusted odds ratio [aOR] = 7.85, 95% confidence interval [CI] = 1.83-33.63, p = 0.006). The presence of CHIP was significantly associated with the initial National Institutes of Health Stroke Scale (NIHSS) score (\u03b2 = 1.67, p = 0.022). Furthermore, CHIP was independently associated with the occurrence of hemorrhagic transformation (65\/110 clonal hematopoiesis positive [CH+] vs 56\/270 CH negative [CH-], aOR = 5.63, 95% CI = 3.24-9.77, p &lt; 0.001) and 90-day functional disability (72\/110 [CH+] vs 99\/270 [CH-], aOR = 2.15, 95% CI = 1.20-3.88, p = 0.011).<\/p>\n\n\n\n<p><strong>Interpretation:&nbsp;<\/strong>CH was significantly associated with incident AIS. Moreover, particularly, sequence variations in PPM1D, TET2, and DNMT3A represent a new prognostic factor for AIS. ANN NEUROL 2023;94:836-847.<\/p>\n","protected":false},"featured_media":0,"parent":0,"template":"","class_list":["post-1780","publication","type-publication","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nobomedicine.com\/index.php?rest_route=\/wp\/v2\/publication\/1780","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nobomedicine.com\/index.php?rest_route=\/wp\/v2\/publication"}],"about":[{"href":"https:\/\/www.nobomedicine.com\/index.php?rest_route=\/wp\/v2\/types\/publication"}],"wp:attachment":[{"href":"https:\/\/www.nobomedicine.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1780"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}