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Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension

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 th...

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Autores principales: Binder, Julia, Palmrich, Pilar, Kalafat, Erkan, Pateisky, Petra, Öztürk, Ebru, Mittelberger, Johanna, Khalil, Asma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649241/
https://www.ncbi.nlm.nih.gov/pubmed/34459247
http://dx.doi.org/10.1161/JAHA.120.020631
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author Binder, Julia
Palmrich, Pilar
Kalafat, Erkan
Pateisky, Petra
Öztürk, Ebru
Mittelberger, Johanna
Khalil, Asma
author_facet Binder, Julia
Palmrich, Pilar
Kalafat, Erkan
Pateisky, Petra
Öztürk, Ebru
Mittelberger, Johanna
Khalil, Asma
author_sort Binder, Julia
collection PubMed
description 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.
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spelling pubmed-86492412022-01-14 Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension Binder, Julia Palmrich, Pilar Kalafat, Erkan Pateisky, Petra Öztürk, Ebru Mittelberger, Johanna Khalil, Asma J Am Heart Assoc Original Research 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. John Wiley and Sons Inc. 2021-08-28 /pmc/articles/PMC8649241/ /pubmed/34459247 http://dx.doi.org/10.1161/JAHA.120.020631 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Binder, Julia
Palmrich, Pilar
Kalafat, Erkan
Pateisky, Petra
Öztürk, Ebru
Mittelberger, Johanna
Khalil, Asma
Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title_full Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title_fullStr Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title_full_unstemmed Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title_short Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
title_sort prognostic value of angiogenic markers in pregnant women with chronic hypertension
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649241/
https://www.ncbi.nlm.nih.gov/pubmed/34459247
http://dx.doi.org/10.1161/JAHA.120.020631
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