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ECLAMPSIA: A 14 YEAR FOLLOW-UP STUDY
E1908 JACC March 27, 2012 Volume 59, Issue 13
Quality of Care and Outcomes Assessment CARDIOVASCULAR OUTCOMES IN WOMEN WITH AND WITHOUT PREECLAMPSIA/ECLAMPSIA: A 14 YEAR FOLLOW-UP STUDY ACC Moderated Poster Contributions McCormick Place South, Hall A Monday, March 26, 2012, 11:00 a.m.-Noon
Session Title: Age, Gender, and Racial Differences in Care Abstract Category: 31. Quality of Care and Outcomes Assessment Presentation Number: 1259-415 Authors: Mary Downes Gastrich, Sampada K. Gandhi, John Pantazopoulos, Edith Zang, Nora M. Cosgrove, Javier Cabrera, John B. Kostis, For the Myocardial Infarction Data Acquisition System (MIDAS) Study Group, UMDNJ/RWJMS, New Brunswick, NJ, USA Background: Population-based studies suggest that women with preeclampsia/eclampsia (PE/E) or hypertension during pregnancy are at increased risk of cardiovascular sequalae compared to women with normotensive pregnancies. No studies have examined the risk of subsequent cardiovascular events such as myocardial infarction (MI) and stroke in women with PE/E and an index MI/stroke. Methods: Women with PE/E (15-49 years) were identified using the Myocardial Infarction Data Acquisition System database in New Jersey from years 1994-2007 and followed up to determine cardiovascular events and survival. ICD codes were used to identify cases and controls. Women with PE/E who experienced MI/stroke for the first time (Case1, N=34/106) were compared with women without PE/E who had MI/stroke for the first time (Control1, N=92/303). Women with PE/E and an index MI/stroke on the same admission (Case2, N=17/80) were compared to women with PE/E but without a MI/stroke on the same admission (Control2, N=48/232). Outcomes were defined as the subsequent occurrence of MI, stroke, congestive heart failure (CHF), and death. Event rates were compared between cases and controls using the Cox proportional hazards regression model. Results: With regard to MI, women in the Control 1 group were at a significantly higher risk of death compared to women in the Case 1 group [Hazard Ratio (HR)=8.16, 95% Confidence Interval (CI) =1.06, 63.05]. Women in the Case 2 group were at a significantly higher risk of CHF compared to women in the Control 2 group (HR=6.44, 95% CI=1.80, 22.98). With regard to stroke, women in the Control 1 group were at a significantly higher risk of experiencing any event (whichever occurred first) compared to women in the Case 1 group (HR=1.63, 95% CI=1.01, 2.63). Women in the Case 2 group were at a significantly higher risk of death compared to women in the Control 2 group (HR=8.50, 95% CI=2.61, 27.70). Conclusions: Women with PE/E and a MI/stroke had better long-term outcomes compared to women with MI/stroke but without PE/E. Women with PE/E and MI/stroke on the same admission had worse long-term outcomes compared to women who had PE/E with no MI/stroke on the same admission.
Quality of Care and Outcomes Assessment CARDIOVASCULAR OUTCOMES IN WOMEN WITH AND WITHOUT PREECLAMPSIA/ECLAMPSIA: A 14 YEAR FOLLOW-UP STUDY ACC Moderated Poster Contributions McCormick Place South, Hall A Monday, March 26, 2012, 11:00 a.m.-Noon
Session Title: Age, Gender, and Racial Differences in Care Abstract Category: 31. Quality of Care and Outcomes Assessment Presentation Number: 1259-415 Authors: Mary Downes Gastrich, Sampada K. Gandhi, John Pantazopoulos, Edith Zang, Nora M. Cosgrove, Javier Cabrera, John B. Kostis, For the Myocardial Infarction Data Acquisition System (MIDAS) Study Group, UMDNJ/RWJMS, New Brunswick, NJ, USA Background: Population-based studies suggest that women with preeclampsia/eclampsia (PE/E) or hypertension during pregnancy are at increased risk of cardiovascular sequalae compared to women with normotensive pregnancies. No studies have examined the risk of subsequent cardiovascular events such as myocardial infarction (MI) and stroke in women with PE/E and an index MI/stroke. Methods: Women with PE/E (15-49 years) were identified using the Myocardial Infarction Data Acquisition System database in New Jersey from years 1994-2007 and followed up to determine cardiovascular events and survival. ICD codes were used to identify cases and controls. Women with PE/E who experienced MI/stroke for the first time (Case1, N=34/106) were compared with women without PE/E who had MI/stroke for the first time (Control1, N=92/303). Women with PE/E and an index MI/stroke on the same admission (Case2, N=17/80) were compared to women with PE/E but without a MI/stroke on the same admission (Control2, N=48/232). Outcomes were defined as the subsequent occurrence of MI, stroke, congestive heart failure (CHF), and death. Event rates were compared between cases and controls using the Cox proportional hazards regression model. Results: With regard to MI, women in the Control 1 group were at a significantly higher risk of death compared to women in the Case 1 group [Hazard Ratio (HR)=8.16, 95% Confidence Interval (CI) =1.06, 63.05]. Women in the Case 2 group were at a significantly higher risk of CHF compared to women in the Control 2 group (HR=6.44, 95% CI=1.80, 22.98). With regard to stroke, women in the Control 1 group were at a significantly higher risk of experiencing any event (whichever occurred first) compared to women in the Case 1 group (HR=1.63, 95% CI=1.01, 2.63). Women in the Case 2 group were at a significantly higher risk of death compared to women in the Control 2 group (HR=8.50, 95% CI=2.61, 27.70). Conclusions: Women with PE/E and a MI/stroke had better long-term outcomes compared to women with MI/stroke but without PE/E. Women with PE/E and MI/stroke on the same admission had worse long-term outcomes compared to women who had PE/E with no MI/stroke on the same admission.