“…Thirdly, IHD promoting systemic responses, of which for example efflorescence of clonal hematopoiesis (CH) in bone marrow [ 62 , 63 , 64 , 65 , 66 ] and splenic hematopoiesis seeding proinflammatory monocytes [ 63 , 67 , 68 ] can be expected to alter blood epitranscriptomic signatures. Mechanistically, these postulations are suggested from notions that: (1) some leukocytes (1a) do exit the plaques [ 69 ], and (1b) oscillate between circulation and ischemic myocardium [ 70 , 71 ], (2) monocytosis has been independently associated with stable IHD and MI [ 72 , 73 ], (3) m 6 A has been shown to partake in dendritic cell (specialized monocytes) activation [ 74 ], (4) METTL3-mediated m 6 A-hypermethylation seems to act as a downstream elicitor of atherogenesis in vascular endothelium in response to disturbed flow and oscillatory shear stress [ 75 ], (5) the plaques, juxtaposed platelets, and ischemic myocardium are known to shed EVs to circulation encasing unique miRNAs [ 59 , 76 , 77 , 78 , 79 , 80 , 81 ], (6) miRNAs in such EVs have recently been shown to be epitranscriptomically modified [ 82 ], (7) epitranscriptomic and epigenetic regulators (7a) are often noted as CH driver mutations [ 83 ], and (7b) are pivotal for proliferation of hematopoietic stem cells (HSCs) [ 31 , 84 , 85 , 86 , 87 , 88 ]. Based on this rationale, the IHD-EPITRAN study aims to identify novel epitranscriptomic biomarkers and drug therapy targets for IHD from blood ( Table 1 ).…”