Cardiovascular Biomarkers in Preeclampsia at Triage

Wellmann, Sven; Benzing, Jörg; Fleischlin, Silvia; Morgenthaler, Nils G.; Fouzas, Sotirios; Bührer, Christoph; Szinnai, Gabor; Burkhardt, Tilo; Lapaire, Olav

doi:10.1159/000361016

Cited by 25 publications

(21 citation statements)

References 20 publications

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“…31 Three other studies have also observed increased maternal copeptin among PE cases. 29, 30, 32 Santillan et al prospectively observed a significant difference in copeptin levels beginning in the first trimester between 20 PE cases and 26 controls. 32 They also observed using an animal model that infusion of vasopressin during pregnancy in mice leads to the clinical phenotypes observed in PE.…”

Section: Discussionmentioning

confidence: 98%

Increased Levels of Copeptin Before Clinical Diagnosis of Preeclampsia

et al. 2014

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Copeptin, a surrogate biomarker of vasopressin, has been associated with renal function decline and may serve as a useful early biomarker for preeclampsia. We measured serum copeptin using samples collected longitudinally during pregnancy among unaffected controls (n=136) and cases of preeclampsia (n=169), gestational diabetes (n=92), gestational hypertension (n=101) and preterm birth (n=86) in the Calcium for Preeclampsia Prevention trial (1992–1995). Preeclampsia and gestational hypertension were defined as having a diastolic blood pressure greater than or equal to 90 millimeters of mercury on two occasions with and without proteinuria, respectively. The risk of pregnancy complications associated with copeptin was estimated by logistic regression adjusting for maternal age, race, body-mass index, insurance status, marital status, current smoking, and clinical site. Baseline copeptin levels, at mean 16 weeks of gestation, were associated with increased preeclampsia risk (adjusted odds ratios and 95% confidence interval being 1.55 per log unit; 1.03–2.31) compared to controls (p=0.03). The association was stronger among cases diagnosed before 37 weeks (1.86; 1.08–3.20) than those diagnosed later (1.45; 0.91–2.32). Copeptin levels rose with increasing gestational age in both cases and controls but remained significantly higher among those who were diagnosed with preeclampsia. Differences in levels of copeptin between cases and controls became more apparent closer to time of diagnosis. No significant associations were found for gestational hypertension without proteinuria, gestational diabetes, or preterm birth without preeclampsia. Copeptin levels are elevated in pregnant women prior to diagnosis of preeclampsia with elevation specific to this pregnancy complication rather than hypertension alone.

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Section: Discussionmentioning

confidence: 98%

Increased Levels of Copeptin Before Clinical Diagnosis of Preeclampsia

et al. 2014

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“…Interestingly, during our revision process, Wellmann et al reported elevated MR-proADM in preeclampsia using a similarly sized cohort [15]. However, their study did not distinguish between mild and severe preeclampsia and included two key groups of patients that we excluded from our study: patients carrying multiple pregnancies and smokers.…”

Section: Discussionmentioning

confidence: 99%

Midregional pro-adrenomedullin plasma concentrations are blunted in severe preeclampsia

et al. 2014

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Levels of the peptide hormone adrenomedullin (AM) are elevated during normal pregnancy, but whether this differs during complications of pregnancy remains unresolved. AM can be quantified by measuring its preprohormone byproduct, midregional pro-adrenomedullin (MR-proADM). MR-pro ADM has shown prognostic value as a biomarker of heart failure, sepsis, and community-acquired pneumonia. Given the relevance of AM to pregnancy, we tested the hypothesis that MR-proADM provides a biomarker for preeclampsia. We find that MR-proADM plasma concentrations are blunted in severe preeclampsia and that MR-proADM is similarly effective as established biomarkers endoglin and placental growth factor at discriminating patients with severe preeclampsia from controls.

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“…14 Earlier reports showed that copeptin is a potent predictor of preeclampsia and may be involved in its pathogenesis. 10 15 Furthermore, Santillan et al . 16 recently showed that elevated maternal plasma copeptin is a highly significant predictor of preeclampsia as early as the 6 th week of gestation.…”

Section: Introductionmentioning

confidence: 99%

Serum copeptin and pregnancy outcome in preeclampsia

et al. 2015

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Background:A number of biochemical predictors of preeclampsia have been reported, but little is known about their possible relationship with maternal and fetal outcomes. This study determined serum copeptin in pregnant women with preeclampsia and assessed its relationship with pregnancy outcomes.Materials and Methods:Thirty women with severe preeclampsia (SP), 30 with mild preeclampsia (MP), and 30 with uncomplicated pregnancy were enrolled into this study. Serum copeptin, creatinine, and liver function were determined using enzyme-linked immunosorbent assay and colorimetry as appropriate. Pregnancy outcomes, both maternal and fetal, were taken using standard methods.Results:Copeptin was significantly elevated in preeclampsia subjects compared with controls and in SP compared with MP. Assessing the diagnostic property of copeptin for preeclampsia, the area under the curve for copeptin was 0.99. Nine (30%) and 3 (10%) of SP and MP, respectively had abruptio placenta while 6 (20%), 2 (6.7%), and 1 (3.3%) still births were recorded in SP, MP, and controls, respectively. Neonates of mothers with preeclampsia had significantly lower birth weight, infant length, ponderal index, and head circumference compared with neonates of the controls. Copeptin had a significant inverse relationship with birth weight, ponderal index, head circumference, Apgar score, and infant length in neonates of mothers with preeclampsia.Conclusion:Serum copeptin level in the third trimester could predict preeclampsia and its elevation is associated with adverse perinatal outcome.

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Cardiovascular Biomarkers in Preeclampsia at Triage

Cited by 25 publications

References 20 publications

Increased Levels of Copeptin Before Clinical Diagnosis of Preeclampsia

Increased Levels of Copeptin Before Clinical Diagnosis of Preeclampsia

Midregional pro-adrenomedullin plasma concentrations are blunted in severe preeclampsia

Serum copeptin and pregnancy outcome in preeclampsia

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