STEMI, revascularization, and peak troponin by adverse pregnancy outcomes in women with myocardial infarction

Moa Handmark*, Annie Lin, Andreas Edsfeldt, Giovanna Sarno, Abigail Fraser, Janet W Rich-Edwards, Isabel Gonçalves, Mats Pihlsgård, Simon Timpka

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

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 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.
Original languageEnglish
Article number101088
Number of pages10
JournalJACC Advances
Volume3
Issue number8
Early online date5 Jul 2024
DOIs
Publication statusPublished - 1 Aug 2024

Bibliographical note

Publisher Copyright:
© 2024, The Authors.

Research Groups and Themes

  • Bristol Population Health Science Institute

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