Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia

Laura Benschop; Laura Brouwers; Gerbrand A. Zoet; Cindy Meun; Eric Boersma; Ricardo P.J. Budde; Bart C.J.M. Fauser; Christianne M.J. De Groot; Yvonne T. Van Der Schouw; Angela H.E.M. Maas; Birgitta K. Velthuis; Katie M. Linstra; Maryam Kavousi; Johannes J. Duvekot; Arie Franx; Eric Steegers; Bas B. Van Rijn; Jeanine E.Roeters Van Lennep

doi:10.1161/CIRCIMAGING.119.010340

Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia

Laura Benschop, Laura Brouwers, Gerbrand A. Zoet, Cindy Meun, Eric Boersma, Ricardo P.J. Budde, Bart C.J.M. Fauser, Christianne M.J. De Groot, Yvonne T. Van Der Schouw, Angela H.E.M. Maas, Birgitta K. Velthuis, Katie M. Linstra, Maryam Kavousi, Johannes J. Duvekot, Arie Franx, Eric Steegers, Bas B. Van Rijn, Jeanine E.Roeters Van Lennep^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5-12.2] versus odds ratio, 1.2 [95% CI, 0.6-2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8-8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406; Unique identifier: NTR5531.

Original language	English
Article number	e010340
Journal	Circulation: Cardiovascular Imaging
Volume	13
Issue number	11
DOIs	https://doi.org/10.1161/CIRCIMAGING.119.010340
Publication status	Published - 1 Nov 2020

Keywords

angiography
atherosclerosis
cardiovascular disease
pregnancy
risk

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10.1161/CIRCIMAGING.119.010340

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Benschop, L., Brouwers, L., Zoet, G. A., Meun, C., Boersma, E., Budde, R. P. J., Fauser, B. C. J. M., De Groot, C. M. J., Van Der Schouw, Y. T., Maas, A. H. E. M., Velthuis, B. K., Linstra, K. M., Kavousi, M., Duvekot, J. J., Franx, A., Steegers, E., Van Rijn, B. B., & Van Lennep, J. E. R. (2020). Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia. Circulation: Cardiovascular Imaging, 13(11), Article e010340. https://doi.org/10.1161/CIRCIMAGING.119.010340

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title = "Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia",

abstract = "Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5-12.2] versus odds ratio, 1.2 [95% CI, 0.6-2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8-8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406; Unique identifier: NTR5531.",

keywords = "angiography, atherosclerosis, cardiovascular disease, pregnancy, risk",

author = "Laura Benschop and Laura Brouwers and Zoet, {Gerbrand A.} and Cindy Meun and Eric Boersma and Budde, {Ricardo P.J.} and Fauser, {Bart C.J.M.} and {De Groot}, {Christianne M.J.} and {Van Der Schouw}, {Yvonne T.} and Maas, {Angela H.E.M.} and Velthuis, {Birgitta K.} and Linstra, {Katie M.} and Maryam Kavousi and Duvekot, {Johannes J.} and Arie Franx and Eric Steegers and {Van Rijn}, {Bas B.} and {Van Lennep}, {Jeanine E.Roeters}",

year = "2020",

month = nov,

day = "1",

doi = "10.1161/CIRCIMAGING.119.010340",

language = "English",

volume = "13",

journal = "Circulation: Cardiovascular Imaging",

issn = "1941-9651",

publisher = "Lippincott Williams & Wilkins",

number = "11",

}

Benschop, L, Brouwers, L, Zoet, GA, Meun, C, Boersma, E, Budde, RPJ, Fauser, BCJM, De Groot, CMJ, Van Der Schouw, YT, Maas, AHEM, Velthuis, BK, Linstra, KM, Kavousi, M, Duvekot, JJ, Franx, A, Steegers, E, Van Rijn, BB & Van Lennep, JER 2020, 'Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia', Circulation: Cardiovascular Imaging, vol. 13, no. 11, e010340. https://doi.org/10.1161/CIRCIMAGING.119.010340

TY - JOUR

T1 - Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia

AU - Benschop, Laura

AU - Brouwers, Laura

AU - Zoet, Gerbrand A.

AU - Meun, Cindy

AU - Boersma, Eric

AU - Budde, Ricardo P.J.

AU - Fauser, Bart C.J.M.

AU - De Groot, Christianne M.J.

AU - Van Der Schouw, Yvonne T.

AU - Maas, Angela H.E.M.

AU - Velthuis, Birgitta K.

AU - Linstra, Katie M.

AU - Kavousi, Maryam

AU - Duvekot, Johannes J.

AU - Franx, Arie

AU - Steegers, Eric

AU - Van Rijn, Bas B.

AU - Van Lennep, Jeanine E.Roeters

PY - 2020/11/1

Y1 - 2020/11/1

N2 - Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5-12.2] versus odds ratio, 1.2 [95% CI, 0.6-2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8-8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406; Unique identifier: NTR5531.

AB - Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5-12.2] versus odds ratio, 1.2 [95% CI, 0.6-2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8-8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406; Unique identifier: NTR5531.

KW - angiography

KW - atherosclerosis

KW - cardiovascular disease

KW - pregnancy

KW - risk

UR - http://www.scopus.com/inward/record.url?scp=85096271486&partnerID=8YFLogxK

U2 - 10.1161/CIRCIMAGING.119.010340

DO - 10.1161/CIRCIMAGING.119.010340

M3 - Article

C2 - 33190533

AN - SCOPUS:85096271486

SN - 1941-9651

VL - 13

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

IS - 11

M1 - e010340

ER -

Early Onset of Coronary Artery Calcification in Women with Previous Preeclampsia

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