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Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary

Şeref Kul1, Tolga Sinan Güvenç2, Ömer Faruk Baycan1

  • 1Istanbul Medeniyet University, Faculty of Medicine, Division of Cardiology, Istanbul, Turkey.

Microvascular Research
|November 15, 2020
PubMed

Insights

A history of preeclampsia and gestational diabetes combined significantly increases coronary microvascular dysfunction (CMD) risk. This highlights a heightened risk for future cardiovascular events in affected women.

Area of Science:

  • Cardiovascular research
  • Reproductive health
  • Atherosclerosis research

Background:

  • Preeclampsia (pPE) and gestational diabetes (pGDM) are known risk factors for atherosclerosis and cardiovascular disease.
  • Pregnancy complications like pPE and pGDM may directly accelerate atherosclerosis by causing endothelial dysfunction.
  • The combined impact of pPE and pGDM on cardiovascular risk remains unclear.

Purpose of the Study:

  • To investigate the prevalence of coronary microvascular dysfunction (CMD) in women with a history of both preeclampsia and gestational diabetes.
  • To compare CMD prevalence in combined pPE/pGDM cases with isolated pPE, isolated pGDM, and healthy controls.

Main Methods:

  • Study included 24 patients with combined pPE/pGDM, 19 with isolated pPE, 63 with pGDM, and 36 healthy controls.
  • Coronary flow reserve (CFR) was measured using echocardiography.
  • Coronary microvascular dysfunction (CMD) was defined as CFR ≤2.5.

Main Results:

  • A high prevalence of CMD (91%) was observed in the combined pPE/pGDM group.
  • CMD prevalence was significantly higher in combined pPE/pGDM patients compared to controls (5.6%) and pGDM patients (55%).
  • A history of pPE with pGDM independently increased CMD risk (HR: 6.28) after adjustment.

Conclusions:

  • Combined preeclampsia and gestational diabetes is associated with a very high prevalence of coronary microvascular dysfunction.
  • This finding suggests a potentially elevated risk for future cardiovascular events in women with this combined pregnancy history.
  • Further research is warranted to elucidate the long-term cardiovascular implications.
Abstract

Keywords:
Coronary flow reserveGestational diabetesMicrovascular dysfunctionPreeclampsia

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