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Markers of endothelial dysfunction as predictors of recurrent severe preeclampsia

M. Nikolaeva1, A. Momot2, V. Terekhina3, A. Kudinov3

1Department of Obstetrics and Gynaecology, Altai State Medical University, Barnaul, Russian Federation, Barnaul, Altaisky krai, Russia, 2Altai Branch of FSBI «National Research Center for Hematology» Russian Ministry of Healthcare, Barnaul, Altaisky krai, Russia, 3ФГБОУ ВО АГМУ МЗ РФ, Barnaul, Altaisky krai, Russia

Abstract Number: VPB1419

Meeting: ISTH 2022 Congress

Theme: Women’s Health » Pregnancy and Pregnancy Complications

Background: Women with a history of severe preeclampsia (PE) are at high risk of disease recurrence, which is realized in 10-25% of women. Taking into account the theory of pathogenesis of PE, the study of circulating biomarkers of endothelial dysfunction, such as endothelin-1 (ET-1) and endothelial microvesicles (EVs), looks promising.

Aims: To study the role of endothelial dysfunction markers in predicting the recurrence of early preeclampsia.

Methods: A prospective randomized observational study was conducted including 127 women with a history of severe early PE. The inclusion point is the preconception period (PC). The endpoint is delivery, the surrogate points – the level of ET-1 (pmol/ml) and endothelial EVs at the PC period and at 11-12, 19-21 and 27-28 weeks of gestation. Before the end of the study, 30 patients were excluded from the study according to the inclusion/exclusion criteria. The remaining 97 patients were randomized into 2 groups according to the observed pregnancy outcomes: one with a beneficial gestation course and delivery at term (control group, n=59) and another one with recurrent severe PE in the present pregnancy (main group, n=38).

Results: The study at the PC period showed that the median (Me) of ET-1 level was Me=0.55 [95%CI:0.39-0.90] in the main group versus Me=0.40 [95%CI:0.27-0.65] in the control group (p=0.0382). The same data were obtained in the study of endothelial EVs, the level of which was significantly higher in women with realized PE, in relation to the control group: Me=21.8 [95%CI:20.2-32.6] and Me=14.5 [95%CI:13.4-17.3] (p=0.0021), respectively.

The ROC analysis showed that the level of endothelin> 0.514 (AUC-0.609; 95%CI:0.559-0.745), as well as the level of endothelial EVs> 1.71 (AUC-0.648; 95%CI:0.453-0.813) had a predictive ability of moderate strength.

Conclusion(s): The findings seem to be a background for the use of biomarkers of endothelial dysfunction as a prognostic predictor of recurrent PE starting from the PC period.

To cite this abstract in AMA style:

Nikolaeva M, Momot A, Terekhina V, Kudinov A. Markers of endothelial dysfunction as predictors of recurrent severe preeclampsia [abstract]. https://abstracts.isth.org/abstract/markers-of-endothelial-dysfunction-as-predictors-of-recurrent-severe-preeclampsia/. Accessed October 1, 2023.

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