Key result
Prior preeclampsia and CAC linked to ~4-fold higher CVD or CKD risk in postmenopausal women.
Why the study?
Compared to men, women with similar CAC scores face higher CVD mortality, prompting investigation into whether circulatory factors like EVs, metabolites, and a history of preeclampsia are associated with CAC.
Are plasma metabolites, extracellular vesicles, and history of preeclampsia associated with coronary artery calcification and subsequent cardiovascular disease in postmenopausal women?
Are plasma metabolites, extracellular vesicles, and history of preeclampsia associated with coronary artery calcification and subsequent cardiovascular disease in postmenopausal women?
Specific plasma metabolites, extracellular vesicles, and a history of preeclampsia are associated with coronary artery calcification and increased risk of future cardiovascular disease in postmenopausal women.
May warrant closer CVD/CKD monitoring in this subgroup; hypothesis-generating for integrating preeclampsia history into postmenopausal CAC risk models.
Background: Compared to men, women with similar coronary artery calcification (CAC) scores face higher cardiovascular disease (CVD) mortality. Objectives: We posited that circulatory factors, like blood-borne extracellular vesicles (EVs) and metabolites, may be associated with the development of CAC and subsequent CVD in postmenopausal women. Additionally, we hypothesized that a history of preeclampsia (PE), a sex-specific risk factor, might be a contributing factor. Methods: Clinical data were obtained from medical records for postmenopausal women (median age 60 years) free of cardiovascular events with (n=29) and without (n=29) CAC. EVs per µL plasma were quantified by digital flow cytometry, and plasma metabolites were measured using gas chromatography-mass spectrometry. CACs were measured by computer tomography and reported as Agatston score. Results: Patients with, versus those without, CAC demonstrated i) less favorable cardiovascular and metabolic profiles; ii) elevation in six EVs populations, including those positive for TF (tissue factor), CD3 (T-cells), SM22α (smooth muscle cells), Pref-1 (adipocytes), FABP4 (adipocytes/macrophages) and p16 (senescent cells); iii) significantly higher levels of proline, allothreonine (amino acid metabolism) and ribitol (carbohydrate metabolism), and lower levels of lactic acid (carbohydrate metabolism); and iv) significantly increased risk of developing CVD and chronic kidney disease (CKD) (P<0.05 for all). In the CAC positive group, women with PE vs those with normotensive pregnancy histories, demonstrated 4-times higher risk of developing cardiovascular events or CKD later in life (P=0.028). Conclusions: Selected plasma metabolites, EVs and PE history could serve as biomarkers of and potential therapeutic targets for CAC and CVD in postmenopausal women.
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Đokić et al. (2026) studied this question. Postmenopausal women with coronary artery calcification and a history of preeclampsia faced a 4-times higher risk of future cardiovascular events or chronic kidney disease.
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