Healthcare Systems: Cardiovascular Disease Article Comparison

This report presents a comparative analysis of two research articles focusing on cardiovascular disease (CVD) and its implications for healthcare. The first article, by Jaiswal et al. (2017), investigates the link between clonal hematopoiesis of indeterminate potential (CHIP) and the increased risk of atherosclerotic cardiovascular disease. The study utilizes whole-exome sequencing to identify CHIP and correlates it with coronary heart disease, suggesting that somatic mutations lead to CHIP and are proportional to myocardial infarction. The second article, by Rosenson et al. (2016), examines the dysfunction of high-density lipoprotein (HDL) and its role in atherosclerosis, highlighting HDL's protective mechanisms and how dysfunctional HDL particles increase proinflammatory signals. The analysis explores the research methods, target audiences, and potential impact on future healthcare delivery, particularly the roles of Tet2 in CHIP and HDL as therapeutic agents. The report emphasizes the increasing prevalence of CVD, diabetes, and hypertension and the need for cardiovascular check-ups, providing insights into potential interventions and preventive measures derived from these studies. Both studies provide new intervention and preventive measures, the contribution of Tet 2 as a risk factor and HDL as a therapeutic agent has the potential to deliver enhanced health service.

Running head:HEALTHCARE SYSTEMS
HEALTHCARE SYSTEMS
Name of the student
Name of the university
Author note

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Part 1
Article Comparison Table
Criteria Article One Article Two
Citation Jaiswal, S., Natarajan, P., Silver,
A. J., Gibson, C. J., Bick, A. G.,
Shvartz, E., ... & Baber, U. (2017).
Clonal hematopoiesis and risk of
atherosclerotic cardiovascular
disease. New England Journal of
Medicine, 377(2), 111-121.
Rosenson, R. S., Brewer
Jr, H. B., Ansell, B. J.,
Barter, P., Chapman, M.
J., Heinecke, J. W., ... &
Webb, N. R. (2016).
Dysfunctional HDL and
atherosclerotic
cardiovascular
disease. Nature reviews
cardiology, 13(1), 48.
Content Summary
Craft a 100-150 word
summary of the article
Clonal indeterminate potential
hematopoiesis (CHIP) which is
characterized as the presence of an
enlarged somatic blood –cell lone
in individuals with no other
hematological abnormalities, is
associate with increased risk of
hematological cancer. The
presence of CHIP in peripheral
blood cells has been associated
with almost a doubling of the risk
of coronary heart disease in
HDL protects against
atherosclerosis by means
of multiple mechanisms
including endothelial
dysfunction
improvement, removal of
excess cholesterol from
the macrophage and
antioxidant, anti-
apoptotic and anti-
inflammatory effects.
DDL loses its

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humans and increased
atherosclerosis in mice. Clonal
hematopoiesis may be a modifiable
risk factor, perhaps by using
cholesterol-lowering drugs or by
targeting particular inflammatory
tracts.
atheroprotective
properties under specific
circumstances, resulting
in the development of
dysfunctional HDL
particles. These particles
increase proinflammatory
signals and decrease the
cholesterol efflux from
macrophage by the ATP-
binding cassette
transporter A1.
Research Methods
Describe the methods used,
including tools, systems, etc.
To evaluate the early onset of
myocardial infarction or the
presence of CHIP – the whole-
exome sequencing method was
used.
The fluorescence-based
assay
The focus of the
Research or Study
Describe the design of the
relevant research or study in
the article.
Whole exome sequencing was
used to identify the presence of
CHIP in peripheral blood cells and
correlated it with coronary heart
disease using samples from four
case-control studies that included
4726 participates with coronary
heart disease and 3529 controls. To
The macrophage
cholesterol efflux
capacity measurements
are done using standards
labeled cholesterol and
fluorescent BODIPY-
cholesterol although
fluorescence-based assay

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test causality, the activity of TEt 2
was disrupted, which is the second
most mutated gene associated with
clonal hematopoiesis in
atherosclerosis-pronounced mice’s
hematopoietic cells.
gave more consistent
evidence with CVD
events among the
participants.
Target Audiences and
Subjects
Identify the target audience
(population) and
the setting in which the
research/study was conducted.
The research was conducted
among the individuals who are
affected with cardiovascular
disease along with diabetes and
hypertension.
The targeted group was
the patients who
developed atherosclerosis
in the course of their life.
Potential Impact on
Future Health Care
Delivery
Propose how this information
could or will impact future
health care delivery or
options.
A potential factor for worsening
atherosclerosis is detected, and
preventive measures will be taken
so that Tet2 in CHIP is not
mutated.
This research might lead
to therapeutic approaches
to atherosclerotic
cardiovascular disease.
Part 2
Cardiovascular disease, diabetes and hypertension are the burning topics of discussion in the
medical field. It is the most leading chronic disease with life-threatening consequences. The
two major conditions of CVD is ischemic heart disease and cerebrovascular disease which
ranks the world’s first and second cause of death respectively. Cardiovascular disease (CVD)
is highly related to diabetes and hypertension. The building up of cholesterol, fats and other
substance on the artery walls is known as atherosclerotic cardiovascular disease. The walls of

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the arteries are found to be filled with cholesterol plaque thus narrowing down the arteries
and that leads to obstruction of the blood flow and this is known as coronary artery disease.
The passage of the arteries falls short for the passage of oxygen and nutrients from the heart
to the rest of the body. The plaque formation is mainly due to the deposition of cholesterol,
fats and calcium in the arteries. As per the study, it has been studied that about 18 million
Americans age 20 and above are affected with CVD and about 800,000 Americans have a
heart attack each year. High blood pressure, smoking, diabetes, high cholesterol obesity are
the main contributors to cardiovascular disease, for which about 650,000 Americans die of
cardiovascular disease every year, among which 25% die of coronary heart disease. In the
united states, women die from coronary heart disease and men die from atherosclerosis.
Out of two studies, one study provides an idea of clonal hematopoiesis of indeterminate
potential (CHIP) and its impact on doubling the risk of coronary heart disease in humans. In
this research, it has been found that somatic mutation leads to CHIP and is directly
proportional to the early onset of myocardial infarction (Jaiswal et al., 2017). The second
study understands the features and dysfunction of HDL, which might lead to therapeutic
approaches to atherosclerotic cardiovascular disease. The main constituent of HDL is
apolipoprotein A-I which has antiatherosclerotic effect as HDL has a functional property of
cholesterol efflux. The study says the HDL dysfunction is noticed in patients with diabetes
mellitus. The significance of this research is it has been found that artherosceloris can be
prevented by HDL through several mechanisms that comprise of amelioration of endothelial
dysfunction, anti-oxidative, removal of excess cholesterol from macrophage and
antiapoptotic effects. The dysfunctional HDL particle is formed when HDL loses its
atheroprotective properties, thus increasing proinflammatory signaling (Rosenson et al.,
2016).

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From the first study, it can be said that in four different studies involving human subjects, it
has been observed that somatic mutations lead to CHP and had a major association with the
risk of coronary heart disease or early onset of myocardial infection. In a murine model of
atherosclerosis, the loss of Tet2 activity is triggered in a hematopoietic cell. The function of
the mutated gene of CHIP that is Tet 2 is highlighted which says it worsens atherosclerosis in
mice. The coronary events in humans are related to the size of the clone. The altered
transcriptional output alters the risk of coronary events. The second study highlights on HDL
and is supposed to provide a therapeutic measure of atherosclerosis. So a dysfunctional HDL
particle reduces the efflux of cholesterol from the macrophage.
The prevalence and incidence rate of CVD is increasing drastically among the men and
women of the United States. Along with the increasing rate of CVD, the disease is directly
proportional to diabetes and hypertension. Diabetic patients are more prone to myocardial
infarction. Hypertension is a potential contributor to CVD. The healthcare system diagnosing
diabetic patients and individuals with hypertension is recommended to consider a
cardiovascular check-up. Along with the increase of CVD, the reason for the disease is
becoming hard to comprehend. Both of the research studies have provided new intervention
and preventive measures. The contribution of Tet 2 as a risk factor and HDL as a therapeutic
agent has the potential to deliver enhanced health service.
From the research, it has been comprehended that HDL works as a potential antioxidative,
antiapoptotic, anti-inflammatory factors. The function of HDL provides a way to new cure
CVD while increasing the cholesterol efflux from the macrophage. Form the other study the
function of Tet 2 in CHIP is analyzed which can be further studied in detail to stop its
mutation that is responsible for cardiovascular disease.
The health professionals can gather more insights on Tet 2 and monitor its function and
assess the pathway through which mutation occurs. The identification of the pathway will

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lead to the new invention through which the mutation could be stopped. According to the
second study, the role of HDL must be analyzed more properly so that more research can be
done on the HDL particle and thus be used as a potential therapeutic agent.
Reference
Jaiswal, S., Natarajan, P., Silver, A. J., Gibson, C. J., Bick, A. G., Shvartz, E., ... & Baber, U.
(2017). Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease. New
England Journal of Medicine, 377(2), 111-121.
Rosenson, R. S., Brewer Jr, H. B., Ansell, B. J., Barter, P., Chapman, M. J., Heinecke, J.
W., ... & Webb, N. R. (2016). Dysfunctional HDL and atherosclerotic cardiovascular
disease. Nature reviews cardiology, 13(1), 48.