Preeclampsia linked to myocardial injury in patients having noncardiac surgery: PREECLAMPSIA-VISION trial

AUSTRALIA: According to a study in the Canadian Journal of Cardiology, preeclampsia poses a risk and is linked to myocardial injury in patients undergoing noncardiac surgery.

Preeclampsia, a multi-system illness, is one of the primary causes of maternal and newborn morbidity and mortality worldwide, affecting 3-5% of all women with a history of pregnancy. There are still many aspects of preeclampsia that are currently unexplored and understudied. Preeclampsia is recognized to increase long-term cardiovascular morbidity and mortality in female patients. It is uncertain, though, if it raises postoperative cardiovascular morbidity and mortality in female patients.

The goal of the study was to ascertain whether pre-eclampsia is a separate risk factor for postoperative 30-day mortality and myocardial damage after noncardiac surgery (MINS).

For this purpose, a representative sample of 40,004 participants from a large international multicenter cohort study was recruited for this study between August 2007 and November 2013. Only 13,902 participants having a history of pregnancy were included in the analyses. Participants received inpatient noncardiac surgery and were under the age of 45. The investigation focused on women having a history of pregnancy within this group. The authors investigated the relationship between a history of preeclampsia-related pregnancies and the primary outcome of MINS and the secondary result of postoperative mortality within 30 days using multivariable models. MINS was defined as prognostically significant ischemia-induced myocardial damage that happened during or within 30 days of noncardiac surgery.

Conclusive points:

• 976 individuals (7.0%) had a preeclampsia history.
• An elevated risk of MINS was linked to a history of preeclampsia, with an adjusted hazard ratio of 1.26 for this association.
• The 30-day death rate was not substantially correlated with preeclampsia.

The researchers came to the conclusion that pre-eclampsia should be taken into account when determining a woman's preoperative cardiovascular risk because it is a risk factor for MINS.

REFERENCE

McDonald SD, Lee VW. Association of Preeclampsia With Myocardial Injury Among Patients Undergoing Noncardiac Surgery: The PREECLAMPSIA-VISION Study. Can J Cardiol. 2021 Dec;37(12):1934-1941. doi: 10.1016/j.cjca.2021.06.012. Epub 2021 Jun 26. PMID: 34182021.