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Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension.

Binder, J; Palmrich, P; Kalafat, E; Pateisky, P; Öztürk, E; Mittelberger, J; Khalil, A (2021) Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension. J Am Heart Assoc, 10 (17). e020631. ISSN 2047-9980 https://doi.org/10.1161/JAHA.120.020631
SGUL Authors: Khalil, Asma

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Abstract

Background Women with chronic hypertension face a 5- to 6-fold increased risk of developing preeclampsia compared with normotensive women. Angiogenic markers, especially soluble fms-like kinase 1 (sFlt-1) and placental growth factor (PlGF), were identified as clinically useful markers predicting the development of preeclampsia, but data on the prediction of superimposed preeclampsia are scarce. Therefore, we aimed to evaluate the predictive value of the sFlt-1/PlGF ratio for delivery because of superimposed preeclampsia in women with chronic hypertension. Methods and Results This retrospective study included 142 women with chronic hypertension and suspected superimposed preeclampsia. Twenty-seven women (19.0%) delivered because of maternal indications only, 17 women (12.0%) because of fetal indications primarily, and 98 women (69.0%) for other reasons. Women who both delivered because of maternal indications and for fetal indications had a significantly higher sFlt-1/PlGF ratio (median 99.9 and 120.2 versus 7.3, respectively, P<0.001 for both) and lower PlGF levels (median 73.6 and 53.3 versus 320.0 pg/mL, respectively, P<0.001 for both) compared with women who delivered for other reasons. SFlt-1/PlGF ratio and PlGF were strong predictors for delivery because of superimposed preeclampsia, whether for maternal or fetal indications (P<0.05). Half of women with angiogenic imbalance (sFlt-1/PlGF ratio ≥85 or PlGF levels <100 pg/mL) delivered because of maternal or fetal indications within 1.6 weeks (95% CI, 1.0-2.4 weeks). Conclusions Angiogenic marker imbalance in women with suspected superimposed preeclampsia can predict delivery because of maternal and fetal indications related to superimposed preeclampsia and is associated with a significantly shorter time to delivery interval.

Item Type: Article
Additional Information: Copyright © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: angiogenic markers, chronic hypertension, preeclampsia, superimposed preeclampsia
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Am Heart Assoc
ISSN: 2047-9980
Language: eng
Dates:
DateEvent
7 September 2021Published
28 August 2021Published Online
3 May 2021Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 34459247
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113598
Publisher's version: https://doi.org/10.1161/JAHA.120.020631

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