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Williams D, Stout MJ, Rosenbloom JI, et al. Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. 2021;78(23):2281-2290doi: 10.1016/j.jacc.2021.09.1360.
Williams, D., Stout, M. J., Rosenbloom, J. I., Olsen, M. A., Joynt Maddox, K. E., Deych, E., Davila-Roman, V. G., & Lindley, K. J. (2021). Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction. Journal of the American College of Cardiology, 78(23), 2281-2290. https://doi.org/10.1016/j.jacc.2021.09.1360
Williams, Dominique, et al. "Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction." Journal of the American College of Cardiology vol. 78,23 (2021): 2281-2290. doi: https://doi.org/10.1016/j.jacc.2021.09.1360
Williams D, Stout MJ, Rosenbloom JI, Olsen MA, Joynt Maddox KE, Deych E, Davila-Roman VG, Lindley KJ. Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. 2021 Dec 07;78(23):2281-2290. doi: 10.1016/j.jacc.2021.09.1360. PMID: 34857089; PMCID: PMC8647839.
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J Am Coll Cardiol. 2021 Dec 07;78(23):2281-2290. doi: 10.1016/j.jacc.2021.09.1360.

Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction.

Journal of the American College of Cardiology

Dominique Williams, Molly J Stout, Joshua I Rosenbloom, Margaret A Olsen, Karen E Joynt Maddox, Elena Deych, Victor G Davila-Roman, Kathryn J Lindley

Affiliations

  1. Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University in St Louis, St Louis, Missouri, USA.
  2. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  3. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in St Louis, St Louis, Missouri, USA.
  4. Division of Infectious Diseases, Department of Medicine, Division of Public Health Sciences, Department of Surgery, Washington University in St Louis, St Louis, Missouri, USA.
  5. Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University in St Louis, St Louis, Missouri, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in St Louis, St Louis, Missouri, USA. Electronic address: [email protected].

PMID: 34857089 PMCID: PMC8647839 DOI: 10.1016/j.jacc.2021.09.1360

Abstract

BACKGROUND: Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established.

OBJECTIVES: The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia.

METHODS: A retrospective cohort study using the New York and Florida state Healthcare Cost and Utilization Project State Inpatient Databases identified delivery hospitalizations between 2006 and 2014 for women with and without preeclampsia/eclampsia. The authors identified women admitted for HF after discharge from index delivery hospitalization until September 30, 2015, using International Classification of Diseases-9th Revision-Clinical Modification diagnosis codes. Patients were followed from discharge to the first instance of primary outcome (HFpEF hospitalization), death, or end of study period. Secondary outcomes included hospitalization for any HF and HF with reduced ejection fraction, separately. The association between preeclampsia/eclampsia and HFpEF was analyzed using Cox proportional hazards models.

RESULTS: There were 2,532,515 women included in the study: 2,404,486 without and 128,029 with preeclampsia/eclampsia. HFpEF hospitalization was significantly more likely among women with preeclampsia/eclampsia, after adjusting for baseline hypertension and other covariates (aHR: 2.09; 95% CI: 1.80-2.44). Median time to onset of HFpEF was 32.2 months (interquartile range: 0.3-65.0 months), and median age at HFpEF onset was 34.0 years (interquartile range: 29.0-39.0 years). Both traditional (hypertension, diabetes mellitus) and sociodemographic (Black race, rurality, low income) risk factors were also associated with HFpEF and secondary outcomes.

CONCLUSIONS: Preeclampsia/eclampsia is an independent risk factor for future hospitalizations for HFpEF.

Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Keywords: HFpEF; heart failure; preeclampsia; pregnancy; women

Conflict of interest statement

Funding Support and Author Disclosures This study was supported in part by the Washington University Institute of Clinical and Translational Sciences grant UL1 TR002345 from the National Center for Ad

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