Changes in high-sensitivity troponin I dynamics pre and post parturition are phenotype specific.
Preeclampsia is associated with a greater postdelivery troponin rise than normal pregnancy.
Changes in high-sensitivity troponin I dynamics pre and post parturition are phenotype specific.
Hypertensive disorders of pregnancy, such as preeclampsia and/or gestational hypertension, are major contributors to maternal morbidity and future cardiovascular risk.
We evaluated peripartum hs-cTnI dynamics and compared phenotype-specific patterns among preeclampsia, hypertension, and normotensive controls in a retrospective cohort study.
We included 609 participants (788 samples), comprising 90 preeclampsia, 116 hypertension, and 403 normotensive control patients.
Median hs-cTnI concentrations were <2.5 ng/L prior to delivery across all groups and increased significantly after delivery.
Peripartum hs-cTnI slopes were steeper in preeclampsia compared with normotensive controls (β=0.005/h, P=0.013).
Increases > 99 th % URL were uncommon and occurred more often in preeclampsia.
This study provides a systematic assessment of hs-cTnI trajectories during the immediate peripartum period, suggesting delivery is a physiologic cardiovascular "stress test".
Preeclampsia is associated with greater myocardial stress compared with normotensive pregnancies, with patients with hypertension demonstrating intermediate changes.
These data indicate that marked increases in hs-cTnI are rare during normal deliveries and deserve additional diagnostic evaluation.