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Major Adverse Cardiovascular Events Following Coronary Artery Stenting by History of Hypertensive Disorder of Pregnancy

Gunnarsson, Omar Sigurvin LU orcid ; Pihlsgård, Mats LU ; Handmark, Moa LU ; Sarno, Giovanna ; Gonçalves, Isabel LU orcid and Timpka, Simon LU orcid (2024) In Journal of the American Heart Association 13(20).
Abstract

BACKGROUND: A history of hypertensive disorders of pregnancy is associated with at least twice the risk of incident ischemic heart disease. Whether the long-term outcome following treatment with coronary artery stenting is associated to the history of hypertensive disorders of pregnancy is unknown. METHODS AND RESULTS: We included 8364 women (age ≤65 years) undergoing first coronary artery stenting 2006 to 2022 following their first delivery in 1973 or later, linking nationwide data on percutaneous coronary intervention and delivery history. In total, 1122 women (13.4%) had a history of hypertensive disorders of pregnancy. The main outcome, a major adverse cardiovascular event, was defined as any incident myocardial infarction, ischemic... (More)

BACKGROUND: A history of hypertensive disorders of pregnancy is associated with at least twice the risk of incident ischemic heart disease. Whether the long-term outcome following treatment with coronary artery stenting is associated to the history of hypertensive disorders of pregnancy is unknown. METHODS AND RESULTS: We included 8364 women (age ≤65 years) undergoing first coronary artery stenting 2006 to 2022 following their first delivery in 1973 or later, linking nationwide data on percutaneous coronary intervention and delivery history. In total, 1122 women (13.4%) had a history of hypertensive disorders of pregnancy. The main outcome, a major adverse cardiovascular event, was defined as any incident myocardial infarction, ischemic heart disease, cardiac arrest, arrhythmias, angina pectoris, heart failure, cerebral infarction, or sudden death. During a median follow-up time of 5 years, 258 women with a history of hypertensive disorders of pregnancy had a major adverse cardiovascular event, compared with 1465 women without a history of hypertensive disorders of pregnancy (23% versus 20.2%, P=0.028 for log-rank test). Estimates adjusted for patient-and procedural characteristics in proportional hazards regression models suggested that the hazard rate increased only after 4–8 years of follow-up (hazard ratio [HR], 1.36 [95% CI, 1.05–1.78]) and was primarily driven by women with history of gestational hypertension (HR, 2.15 [95% CI, 1.49–3.11]). CONCLUSIONS: Women with a history of hypertensive disorders of pregnancy have an increased risk of a major adverse cardiovascular event following coronary artery stenting compared with other parous women. A history of hypertensive disorders of pregnancy warrants further attention in the secondary prevention setting of coronary artery disease.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular disease, complications, MACE, PCI, preeclampsia
in
Journal of the American Heart Association
volume
13
issue
20
article number
e035448
publisher
Wiley-Blackwell
external identifiers
  • pmid:39392150
  • scopus:85206596365
ISSN
2047-9980
DOI
10.1161/JAHA.124.035448
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Author(s).
id
98178d43-16c4-4f40-a830-f13d588dd45a
date added to LUP
2025-08-21 14:21:37
date last changed
2025-08-21 16:38:22
@article{98178d43-16c4-4f40-a830-f13d588dd45a,
  abstract     = {{<p>BACKGROUND: A history of hypertensive disorders of pregnancy is associated with at least twice the risk of incident ischemic heart disease. Whether the long-term outcome following treatment with coronary artery stenting is associated to the history of hypertensive disorders of pregnancy is unknown. METHODS AND RESULTS: We included 8364 women (age ≤65 years) undergoing first coronary artery stenting 2006 to 2022 following their first delivery in 1973 or later, linking nationwide data on percutaneous coronary intervention and delivery history. In total, 1122 women (13.4%) had a history of hypertensive disorders of pregnancy. The main outcome, a major adverse cardiovascular event, was defined as any incident myocardial infarction, ischemic heart disease, cardiac arrest, arrhythmias, angina pectoris, heart failure, cerebral infarction, or sudden death. During a median follow-up time of 5 years, 258 women with a history of hypertensive disorders of pregnancy had a major adverse cardiovascular event, compared with 1465 women without a history of hypertensive disorders of pregnancy (23% versus 20.2%, P=0.028 for log-rank test). Estimates adjusted for patient-and procedural characteristics in proportional hazards regression models suggested that the hazard rate increased only after 4–8 years of follow-up (hazard ratio [HR], 1.36 [95% CI, 1.05–1.78]) and was primarily driven by women with history of gestational hypertension (HR, 2.15 [95% CI, 1.49–3.11]). CONCLUSIONS: Women with a history of hypertensive disorders of pregnancy have an increased risk of a major adverse cardiovascular event following coronary artery stenting compared with other parous women. A history of hypertensive disorders of pregnancy warrants further attention in the secondary prevention setting of coronary artery disease.</p>}},
  author       = {{Gunnarsson, Omar Sigurvin and Pihlsgård, Mats and Handmark, Moa and Sarno, Giovanna and Gonçalves, Isabel and Timpka, Simon}},
  issn         = {{2047-9980}},
  keywords     = {{cardiovascular disease; complications; MACE; PCI; preeclampsia}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{20}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Major Adverse Cardiovascular Events Following Coronary Artery Stenting by History of Hypertensive Disorder of Pregnancy}},
  url          = {{http://dx.doi.org/10.1161/JAHA.124.035448}},
  doi          = {{10.1161/JAHA.124.035448}},
  volume       = {{13}},
  year         = {{2024}},
}