Journal
AMERICAN JOURNAL OF CARDIOLOGY
Volume 107, Issue 2, Pages 325-330Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2010.08.073
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Funding
- National Health Research Institute, Taiwan [NHRI-EX95-9108SC, NHRI-EX969627SI]
- National Science Council, Taipei, Taiwan [NSC 96-2314-B182-026, 97-2314-B-182-028-MY2]
- Topnotch Stroke Research Center, Ministry of Education, Taipei, Taiwan
- Center of Excellence for Clinical Trial and Research in Neurology and Neurosurgery, Department of Health, Taipei, Taiwan [DOH-TD-B-111-002]
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There is no large-scale population-based study to clarify the association between major adverse cardiovascular events (MACEs) and pre-eclampsia/eclampsia. A population-based Taiwanese cohort study was performed in 1,132,064 parturients from 1999 to 2003 using a dataset linking birth certificates and National Health Insurance hospital discharge data. Sociodemographic factors and obstetric complications were used in multivariate logistic regression models to determine adjusted hazard ratios of pre-eclampsia/eclampsia on risks of MACEs and mortality during pregnancy to at least the third year postpartum. Incidence rates of MACEs and all maternal mortality in women with pre-eclampsia/eclampsia were 16.21 and 40.38 per 100,000 patients per year, respectively. Women with pre-eclampsia/eclampsia had a 13.0-fold higher incidence of myocardial infarction, a 8.3-fold higher incidence of heart failure, a 14.5-fold higher incidence of stroke, a 12.6-fold higher incidence of MACEs, a 7.3-fold higher incidence of MACEs without stroke, a 2.3-fold higher incidence of MACE-related deaths, and a 6.4-fold higher incidence of overall death than women without pre-eclampsia/eclampsia. Kaplan-Meier survival curve discriminated in MACEs, nonstroke MACEs, MACE related death and overall death. In conclusion, women with pre-eclampsia/eclampsia have a significantly higher risk of MACEs, especially myocardial infarction and stroke, during pregnancy and their risk remains significant to >= 36 months postpartum. Our results suggest that women with pre-eclampsia/eclampsia should be closely monitored during pregnancy and for up to >= 3 years postpartum. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:325-330)
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