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Cardiovascular risk evaluation in pregnancy: focus on cardiac specific biomarkers
Clerico Aldo1, Zaninotto Martina2, Aimo Alberto3
1Coordinator of the Study Group on Cardiac Biomarkers from Italian Society of Biochemical Chemistry (SIBioC) and European Ligand Assay Society (ELAS), Milan, Italy.
Insights
Cardiac biomarkers like brain natriuretic peptide (BNP) and high-sensitivity cardiac troponin (hs-cTn) can improve cardiovascular risk assessment in pregnant women. Their measurement is crucial for early and accurate evaluation during pregnancy.
Area of Science:
- Cardiology
- Reproductive Medicine
- Biomarker Research
Background:
- Cardiac biomarkers are clinically useful for cardiovascular risk evaluation.
- Current guidelines often overlook cardiac biomarkers for pregnant women.
- Pregnancy involves physiological cardiovascular changes impacting biomarker interpretation.
Purpose of the Study:
- To review the role of cardiac biomarkers in enhancing cardiovascular risk evaluation in pregnancy.
- To examine the relationship between pregnancy physiology and cardiac biomarkers.
- To assess the clinical relevance of specific biomarkers like BNP/NT-proBNP and hs-cTnI/hs-cTnT.
Main Methods:
- Literature review focusing on cardiac biomarkers in pregnancy.
- Analysis of studies on normal and complicated pregnancies.
- Examination of brain natriuretic peptide (BNP)/NT-proBNP and high-sensitivity cardiac troponin (hs-cTn) assays.
Main Results:
- Cardiac biomarkers, including BNP/NT-proBNP and hs-cTnI/hs-cTnT, show potential in improving cardiovascular risk assessment in pregnant individuals.
- Evidence supports their utility in both normal and complicated pregnancies.
- Understanding pregnancy-related physiological changes is key to interpreting biomarker results.
Conclusions:
- Cardiac specific biomarkers can significantly enhance cardiovascular risk evaluation accuracy in pregnant women.
- Further research and integration into clinical practice are advocated for early detection and management.
- Standardized analytical approaches and clear clinical objectives are needed for biomarker utilization.
Abstract:
Despite the evidence demonstrating the clinical utility of cardiac specific biomarkers in improving cardiovascular risk evaluation in several clinical conditions, even the most recent reviews and guidelines fail to consider their measurement in order to enhance the accuracy of the evaluation of cardiovascular risk in pregnant women. The aim of this review article was to examine whether the assay of cardiac specific biomarkers can enhance cardiovascular risk evaluation in pregnant women, first by reviewing the relationships between the physiological state of pregnancy and cardiac specific biomarkers. The clinical relevance of brain natriuretic peptide (BNP)/NT-proBNP and high-sensitivity cardiac troponin I/high-sensitivity cardiac troponin T (hs-cTnI/hs-cTnT) assay in improving cardiovascular risk evaluation is examined based on the results of clinical studies on subjects with normal and those with complicated pregnancy. Finally, the analytical approaches and clinical objectives related to cardio specific biomarkers are advocated in order to allow an early and more accurate evaluation of cardiovascular risk in pregnant women.
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