Coronary Artery Restenosis in Women by History of Preeclampsia

Abstract

Background A history of preeclampsia is associated with increased risk of coronary artery disease and experimental evidence suggests that a history of preeclampsia also increases the risk of restenosis. However, the extent to which a history of preeclampsia is associated with risk of restenosis after percutaneous coronary intervention in women is unknown. Methods and Results We included 6065 parous women aged ≤65 years with first percutaneous coronary intervention on 9452 segments 2006 to 2017, linking nationwide data on percutaneous coronary intervention and delivery history in Sweden. Main outcomes were clinical restenosis and target lesion revascularization within 2 years. We accounted for segment‐, procedure‐, and patient‐related potential predictors of restenosis in proportional hazards regression models. Restenosis occurred in 345 segments (3.7%) and target lesion revascularization was performed on 383 patients (6.3%). A history of preeclampsia was neither significantly associated with risk of restenosis (predictor‐accounted hazard ratio [HR], 0.71 [95% CI, 0.41–1.23]) nor target lesion revascularization (0.74 [95% CI, 0.51–1.07]) compared with a normotensive pregnancy history. When term and preterm preeclampsia were investigated separately, segments in women with a history of term preeclampsia had a lower risk of restenosis (predictor‐accounted HR, 0.45 [95% CI, 0.21–0.94]). A history of preeclampsia was not significantly associated with death by any cause within 2 years of the index procedure (predictor‐accounted HR 1.06, [95% CI, 0.62–1.80]). Conclusions A history of preeclampsia was not associated with increased risk of restenosis but instead some evidence pointed to a decreased risk. To facilitate future studies and allow for replication, concomitant collection of data on pregnancy complication history and percutaneous coronary intervention outcomes in women is warranted.

Keywords

• coronary artery disease
• coronary artery stenting
• hypertensive disorders of pregnancy
• pregnancy
• SCAAR
• SWEDEHEART