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N-terminal pro-B-type natriuretic peptide predicts cardiovascular complications in pregnant women with congenital
Marlies A M Kampman1, Ali Balci, Dirk J van Veldhuisen
1Department of Cardiology, Thorax Centre, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700RB, The Netherlands.
European Heart Journal
|December 17, 2013
Summary
Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at 20 weeks gestation predict cardiovascular events in pregnant women with congenital heart disease (CHD). This biomarker aids in risk assessment for these high-risk pregnancies.
Area of Science:
- Cardiology
- Obstetrics
- Biomarker Research
Background:
- Pregnancy in women with congenital heart disease (CHD) carries a high risk of cardiovascular complications.
- Accurate risk assessment for these pregnancies remains challenging.
Purpose of the Study:
- To evaluate the independent predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels for adverse cardiovascular events during pregnancy in women with CHD.
- To identify key predictors of cardiovascular events in this population.
Main Methods:
- A prospective, multicenter national cohort study involving 213 pregnancies.
- Clinical evaluation, echocardiography, and NT-proBNP measurement at 20-week gestation.
- Analysis of independent predictors for adverse cardiovascular events.
Main Results:
- Adverse cardiovascular events occurred in 10.3% of pregnancies.
- Elevated NT-proBNP levels (>128 pg/mL) at 20 weeks gestation were independently associated with adverse events (OR 10.6).
- Mechanical valve presence and subpulmonary ventricular dysfunction also predicted events. NT-proBNP improved predictive accuracy (AUC 0.90 vs. 0.78).
Conclusions:
- Increased NT-proBNP levels at 20 weeks gestation are a significant independent predictor of cardiovascular events in pregnant women with CHD.
- NT-proBNP measurement provides valuable additional information for risk stratification in these patients.
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