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Coronary Artery Restenosis in Women by History of Preeclampsia

Lin, Annie LU ; Pehrson, Moa LU ; Sarno, Giovanna ; Fraser, Abigail ; Rich-Edwards, Janet W. ; Gonҫalves, Isabel LU orcid ; Pihlsgård, Mats LU and Timpka, Simon LU orcid (2022) In Journal of the American Heart Association 11(18).
Abstract

BACKGROUND: A history of preeclampsia is associated with increased risk of coronary artery disease and experimental evidence suggests that a history of preeclampsia also increases the risk of restenosis. However, the extent to which a history of preeclampsia is associated with risk of restenosis after percutaneous coronary intervention in women is unknown. METHODS AND RESULTS: We included 6065 parous women aged ≤65 years with first percutaneous coronary intervention on 9452 segments 2006 to 2017, linking nationwide data on percutaneous coronary intervention and delivery history in Sweden. Main outcomes were clinical restenosis and target lesion revascularization within 2 years. We accounted for segment-, proce-dure-, and patient-related... (More)

BACKGROUND: A history of preeclampsia is associated with increased risk of coronary artery disease and experimental evidence suggests that a history of preeclampsia also increases the risk of restenosis. However, the extent to which a history of preeclampsia is associated with risk of restenosis after percutaneous coronary intervention in women is unknown. METHODS AND RESULTS: We included 6065 parous women aged ≤65 years with first percutaneous coronary intervention on 9452 segments 2006 to 2017, linking nationwide data on percutaneous coronary intervention and delivery history in Sweden. Main outcomes were clinical restenosis and target lesion revascularization within 2 years. We accounted for segment-, proce-dure-, and patient-related potential predictors of restenosis in proportional hazards regression models. Restenosis occurred in 345 segments (3.7%) and target lesion revascularization was performed on 383 patients (6.3%). A history of preeclampsia was neither significantly associated with risk of restenosis (predictor-accounted hazard ratio [HR], 0.71 [95% CI, 0.41–1.23]) nor target lesion revascularization (0.74 [95% CI, 0.51–1.07]) compared with a normotensive pregnancy history. When term and preterm preeclampsia were investigated separately, segments in women with a history of term preeclampsia had a lower risk of restenosis (predictor-accounted HR, 0.45 [95% CI, 0.21– 0.94]). A history of preeclampsia was not significantly associated with death by any cause within 2 years of the index procedure (predictor-accounted HR 1.06, [95% CI, 0.62–1.80]). CONCLUSIONS: A history of preeclampsia was not associated with increased risk of restenosis but instead some evidence pointed to a decreased risk. To facilitate future studies and allow for replication, concomitant collection of data on pregnancy complication history and percutaneous coronary intervention outcomes in women is warranted.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary artery disease, coronary artery stenting, hypertensive disorders of pregnancy, pregnancy, SCAAR, SWEDEHEART
in
Journal of the American Heart Association
volume
11
issue
18
article number
e026287
publisher
Wiley-Blackwell
external identifiers
  • pmid:36073639
  • scopus:85138408896
ISSN
2047-9980
DOI
10.1161/JAHA.122.026287
language
English
LU publication?
yes
id
905d89ab-39c3-4d7f-9544-19489946494f
date added to LUP
2022-12-05 12:02:30
date last changed
2024-03-21 15:21:56
@article{905d89ab-39c3-4d7f-9544-19489946494f,
  abstract     = {{<p>BACKGROUND: A history of preeclampsia is associated with increased risk of coronary artery disease and experimental evidence suggests that a history of preeclampsia also increases the risk of restenosis. However, the extent to which a history of preeclampsia is associated with risk of restenosis after percutaneous coronary intervention in women is unknown. METHODS AND RESULTS: We included 6065 parous women aged ≤65 years with first percutaneous coronary intervention on 9452 segments 2006 to 2017, linking nationwide data on percutaneous coronary intervention and delivery history in Sweden. Main outcomes were clinical restenosis and target lesion revascularization within 2 years. We accounted for segment-, proce-dure-, and patient-related potential predictors of restenosis in proportional hazards regression models. Restenosis occurred in 345 segments (3.7%) and target lesion revascularization was performed on 383 patients (6.3%). A history of preeclampsia was neither significantly associated with risk of restenosis (predictor-accounted hazard ratio [HR], 0.71 [95% CI, 0.41–1.23]) nor target lesion revascularization (0.74 [95% CI, 0.51–1.07]) compared with a normotensive pregnancy history. When term and preterm preeclampsia were investigated separately, segments in women with a history of term preeclampsia had a lower risk of restenosis (predictor-accounted HR, 0.45 [95% CI, 0.21– 0.94]). A history of preeclampsia was not significantly associated with death by any cause within 2 years of the index procedure (predictor-accounted HR 1.06, [95% CI, 0.62–1.80]). CONCLUSIONS: A history of preeclampsia was not associated with increased risk of restenosis but instead some evidence pointed to a decreased risk. To facilitate future studies and allow for replication, concomitant collection of data on pregnancy complication history and percutaneous coronary intervention outcomes in women is warranted.</p>}},
  author       = {{Lin, Annie and Pehrson, Moa and Sarno, Giovanna and Fraser, Abigail and Rich-Edwards, Janet W. and Gonҫalves, Isabel and Pihlsgård, Mats and Timpka, Simon}},
  issn         = {{2047-9980}},
  keywords     = {{coronary artery disease; coronary artery stenting; hypertensive disorders of pregnancy; pregnancy; SCAAR; SWEDEHEART}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{18}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Coronary Artery Restenosis in Women by History of Preeclampsia}},
  url          = {{http://dx.doi.org/10.1161/JAHA.122.026287}},
  doi          = {{10.1161/JAHA.122.026287}},
  volume       = {{11}},
  year         = {{2022}},
}