Accumulating evidence suggests that conventional cardiovascular risk factors are incompletely predictive of cardiovascular disease, as a substantial risk remains even when these factors are apparently managed well. In this context, clonal hematopoiesis has emerged as a new and potent risk factor for atherosclerotic cardiovascular disease and other cardiometabolic conditions. Clonal hematopoiesis typically arises from somatic mutations that confer a competitive advantage to a mutant hematopoietic stem cell, leading to its clonal expansion in the stem cell population and its progeny of blood leukocytes. Human sequencing studies and experiments in mice suggest that clonal hematopoiesis, at least when driven by certain mutations, contributes to accelerated atherosclerosis development. However, the epidemiology, biology and clinical implications of this phenomenon remain incompletely understood. Here, we review the current understanding of the connection between clonal hematopoiesis and atherosclerosis, and highlight knowledge gaps in this area of research.

越来越多的证据表明，传统的心血管危险因素不能完全预测心血管疾病，因为即使这些因素显然得到妥善管理，仍然存在很大的风险。在这种情况下，克隆性造血已成为动脉粥样硬化性心血管疾病和其他心脏代谢疾病的新的有效危险因素。克隆性造血通常起因于赋予突变造血干细胞竞争优势的体细胞突变，导致其在干细胞群及其血液白细胞后代中的克隆扩增。人体测序研究和小鼠实验表明，至少在某些突变驱动下，克隆性造血有助于加速动脉粥样硬化的发展。然而，流行病学，这种现象的生物学和临床意义仍未完全了解。在这里，我们回顾了目前对克隆性造血和动脉粥样硬化之间联系的理解，并强调了这一研究领域的知识差距。