Maternal cardiac troponin levels in pre-eclampsia: a systematic review

OBJECTIVE: We systematically review the literature for potential alterations in cardiac troponin I (cTnI) in patients who suffer from pre-eclampsia. METHODS: We used the Medline (1966-2015), Scopus (2004-2015), Popline (1974-2015), ClinicalTrials.gov (2008-2015) and Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2015) databases for our primary search; we also employed the reference lists of the full-text articles that we retrieved electronically. RESULTS: We included nine studies involving 719 women. Five of these studies suggested that cTnI increases in pre-eclamptic patients above the normal threshold. However, all studies reported outcomes at a single time point, and they failed to perform consecutive measurements to observe whether this effect was long lasting and whether it evolved during the course of pregnancy. CONCLUSIONS: Current evidence suggests that cTnI might be elevated in pre-eclamptic pregnant women, although this observation is not always reported. Future studies are necessary to consistently observe cTnI levels throughout the prenatal period and during the first few postnatal weeks. A concurrent evaluation of other cardiovascular hemodynamic parameters could be of use in mechanistic models for predicting future cardiovascular morbidity in these women.