Distinct Somatic Mutational Landscapes in Paired Blood and Arterial Tissues in Coronary Artery Disease

The study examined somatic mutations in blood and arterial tissues from 302 patients undergoing coronary artery bypass surgery. Clonal hematopoiesis of indeterminate potential (CHIP) was detected in 7.9% of blood samples, predominantly involving mutations in DNMT3A, TET2, and ASXL1 genes. However, arterial tissues showed different mutations, particularly in CALR, SETDB1, and PDSS2 genes. Blood mutations were associated with lower disease complexity (measured by SYNTAX score), while CALR mutations in arteries were associated with higher complexity. Among 221 paired samples, only four identical mutations were found in both compartments. The findings indicate that blood and arterial tissue have distinctly different mutational profiles with limited mutation sharing between them.