Angiogenic biomarker concentrations and their relation to coronary atherosclerosis in women with a history of preeclampsia: Findings from the CPH-PRECIOUS study.

INTRODUCTION

Preeclampsia is known to be associated with a two- to fourfold elevated risk of developing cardiovascular disease in the first 15 years following pregnancy. In this cross-sectional study of 892 women with prior preeclampsia, we aimed to assess differences in circulating angiogenic biomarker concentrations according to CT-assessed coronary atherosclerosis in women up to 28 years after an index pregnancy complicated by preeclampsia.

MATERIAL AND

METHODS

Women were identified from clinical databases consisting of data from all deliveries within the Capital Region of Denmark from 1995 onwards. Women with prior preeclampsia and a current age between 35 and 55 years were included from the CPH-PRECIOUS cohort. The primary outcome was differences in circulating angiogenic biomarkers according to CT-assessed coronary atherosclerosis.

RESULTS

The median time since the pregnancy complicated by preeclampsia was 12.5 years (range: 0-28 years). PlGF concentrations were significantly higher in women with coronary atherosclerosis (9.6 pg/mL [IQR 4.9-12.6] vs. 7.4 pg/mL [IQR 3.9-11.3], p = 0.001), and subsequently a lower calculated sFlt-1/PlGF ratio (4.2 [IQR 3.1-6.3] vs. 5.0 [IQR 3.6-6.9], p = 0.001) was found. No differences in sFlt-1 concentrations were observed. Higher PlGF concentrations were significantly associated with coronary atherosclerosis; however, associations were attenuated in adjusted analysis.

CONCLUSIONS

This is the first large study to investigate long-term differences in circulating angiogenic biomarker concentrations after preeclampsia, highlighting the complex relationship between angiogenic biomarkers, preeclampsia, and later atherosclerotic burden.