STEMI, Revascularization, and Peak Troponin by Adverse Pregnancy Outcomes in Women With Myocardial Infarction
Handmark, Moa LU ; Lin, Annie LU ; Edsfeldt, Andreas LU ; Sarno, Giovanna ; Fraser, Abigail ; Rich-Edwards, Janet W ; Gonҫalves, Isabel LU
; Pihlsgård, Mats
LU
and Timpka, Simon
LU
(2024)
In JACC: Advances
3(8).
- Abstract
BACKGROUND: Women with a history of adverse pregnancy outcomes have a higher risk of coronary heart disease. Emerging evidence suggests that women with a history of preeclampsia have a different pattern of overall coronary atherosclerosis and that they at the time of myocardial infarction (MI) more frequently present with ST-segment elevation MI (STEMI) compared to women with no such history.
OBJECTIVES: The purpose of this study was to determine whether among women with MI, those with a history of adverse pregnancy outcomes are more likely to present with STEMI or other clinical characteristics indicating a more severe myocardial injury.
METHODS: The study sample consisted of 8,320 women aged ≤65 years with first MI in... (More)
BACKGROUND: Women with a history of adverse pregnancy outcomes have a higher risk of coronary heart disease. Emerging evidence suggests that women with a history of preeclampsia have a different pattern of overall coronary atherosclerosis and that they at the time of myocardial infarction (MI) more frequently present with ST-segment elevation MI (STEMI) compared to women with no such history.
OBJECTIVES: The purpose of this study was to determine whether among women with MI, those with a history of adverse pregnancy outcomes are more likely to present with STEMI or other clinical characteristics indicating a more severe myocardial injury.
METHODS: The study sample consisted of 8,320 women aged ≤65 years with first MI in Sweden 2007 to 2022. Regression models were used to estimate the association between adverse pregnancy outcomes (hypertensive disorders of pregnancy [non-preeclamptic hypertension and preeclampsia], small for gestational age [SGA] infant, and preterm delivery) and STEMI, invasive revascularization, and high troponin, while considering known predictors of coronary heart disease.
RESULTS: In total, 3,128 (38%) of women suffered STEMI. The adjusted OR of presenting with STEMI were higher in women with a history of preterm preeclampsia (OR: 1.40; 95% CI: 1.05-1.88), or an SGA infant (OR: 1.30; 95% CI: 1.13-1.50) compared to women with no such history, as well as for in-hospital revascularization. Stratified by infarct type, troponin levels did not differ by adverse pregnancy outcome history.
CONCLUSIONS: Among women with a first MI, a history of preterm preeclampsia or SGA infant were associated with STEMI and invasive revascularization.
(Less)
- author
- Handmark, Moa
LU
; Lin, Annie
LU
; Edsfeldt, Andreas
LU
; Sarno, Giovanna
; Fraser, Abigail
; Rich-Edwards, Janet W
; Gonҫalves, Isabel
LU
; Pihlsgård, Mats
LU
and Timpka, Simon
LU
- organization
- publishing date
- 2024-08
- type
- Contribution to journal
- publication status
- published
- subject
- in
- JACC: Advances
- volume
- 3
- issue
- 8
- article number
- 101088
- publisher
- American College of Cardiology
- external identifiers
-
- scopus:85197583288
- pmid:39070091
- ISSN
- 2772-963X
- DOI
- 10.1016/j.jacadv.2024.101088
- language
- English
- LU publication?
- yes
- additional info
- © 2024 The Authors.
- id
- 484362b6-a3cf-4723-b1f0-6cbbd6cb6e2f
- date added to LUP
- 2024-08-29 14:25:04
- date last changed
- 2024-08-30 04:01:25
@article{484362b6-a3cf-4723-b1f0-6cbbd6cb6e2f,
abstract = {{<p>BACKGROUND: Women with a history of adverse pregnancy outcomes have a higher risk of coronary heart disease. Emerging evidence suggests that women with a history of preeclampsia have a different pattern of overall coronary atherosclerosis and that they at the time of myocardial infarction (MI) more frequently present with ST-segment elevation MI (STEMI) compared to women with no such history.</p><p>OBJECTIVES: The purpose of this study was to determine whether among women with MI, those with a history of adverse pregnancy outcomes are more likely to present with STEMI or other clinical characteristics indicating a more severe myocardial injury.</p><p>METHODS: The study sample consisted of 8,320 women aged ≤65 years with first MI in Sweden 2007 to 2022. Regression models were used to estimate the association between adverse pregnancy outcomes (hypertensive disorders of pregnancy [non-preeclamptic hypertension and preeclampsia], small for gestational age [SGA] infant, and preterm delivery) and STEMI, invasive revascularization, and high troponin, while considering known predictors of coronary heart disease.</p><p>RESULTS: In total, 3,128 (38%) of women suffered STEMI. The adjusted OR of presenting with STEMI were higher in women with a history of preterm preeclampsia (OR: 1.40; 95% CI: 1.05-1.88), or an SGA infant (OR: 1.30; 95% CI: 1.13-1.50) compared to women with no such history, as well as for in-hospital revascularization. Stratified by infarct type, troponin levels did not differ by adverse pregnancy outcome history.</p><p>CONCLUSIONS: Among women with a first MI, a history of preterm preeclampsia or SGA infant were associated with STEMI and invasive revascularization.</p>}},
author = {{Handmark, Moa and Lin, Annie and Edsfeldt, Andreas and Sarno, Giovanna and Fraser, Abigail and Rich-Edwards, Janet W and Gonҫalves, Isabel and Pihlsgård, Mats and Timpka, Simon}},
issn = {{2772-963X}},
language = {{eng}},
number = {{8}},
publisher = {{American College of Cardiology}},
series = {{JACC: Advances}},
title = {{STEMI, Revascularization, and Peak Troponin by Adverse Pregnancy Outcomes in Women With Myocardial Infarction}},
url = {{http://dx.doi.org/10.1016/j.jacadv.2024.101088}},
doi = {{10.1016/j.jacadv.2024.101088}},
volume = {{3}},
year = {{2024}},
}