Why the study?
Hypertensive disorders of pregnancy contribute significantly to maternal morbidity and long-term cardiovascular disease risk, but high-sensitivity cardiac troponin behavior during the immediate peripartum period remains poorly characterized.
Do hypertensive disorders of pregnancy (preeclampsia and chronic or gestational hypertension) alter peripartum high-sensitivity cardiac troponin I concentrations and temporal trajectories compared with normotensive pregnancies?
Cohort (n=609)
No
Do hypertensive disorders of pregnancy (preeclampsia and chronic or gestational hypertension) alter peripartum high-sensitivity cardiac troponin I concentrations and temporal trajectories compared with normotensive pregnancies?
This study provides the first systematic assessment of peripartum hs-cTnI trajectories, demonstrating that delivery acts as a cardiovascular stress test and that preeclampsia causes disproportionate peripartum myocardial stress compared with normotensive pregnancies.
Answers are grounded in this paper and cite their sources.
Preeclampsia-associated hs-cTnI elevations may signal peripartum myocardial strain; leaves open whether troponin monitoring refines risk stratification.
Hypertensive disorders of pregnancy (HDP), including preeclampsia (PEC) and chronic or gestational hypertension (HTN), are major contributors to maternal morbidity and long-term cardiovascular disease risk, yet high-sensitivity cardiac troponin (hs-cTn) behavior during the immediate peripartum period remains poorly characterized. The objective of this study was to evaluate peripartum hs-cTnI dynamics and compare phenotype-specific patterns among PEC, HTN, and normotensive controls (NC). We conducted a retrospective cohort study of pregnant patients ≥18 years at a tertiary academic medical center, including leftover serum or EDTA plasma samples collected within ±48 hours of delivery. Hs-cTnI was measured using a high-sensitivity immunoassay, and patients with postpartum PEC or preexisting cardiovascular disease were excluded. Mixed-effects linear regression models were used to compare log10-transformed hs-cTnI concentrations and temporal slopes across phenotypes, adjusting for age, race, multifetal gestation, chronic hypertension, nulliparity, pregravid body mass index, blood loss, and delivery type. The study included 609 participants (788 samples), comprising 90 PEC, 116 HTN, and 403 NC patients. Median hs-cTnI concentrations were<2.5 ng/L prior to delivery across all groups and increased significantly after delivery, with the greatest post-delivery rise observed in PEC, followed by HTN and NC. In adjusted analyses, hs-cTnI levels were significantly higher in PEC compared with NC (β = 0.266, p < 0.001) and HTN (β = 0.160, p = 0.011), with HTN also higher than NC (β = 0.107, p = 0.046). Peripartum hs-cTnI slopes were steeper in PEC compared with NC (β = 0.005/h, p = 0.013), while slopes did not differ between PEC and HTN. In conclusion, this study provides the first systematic assessment of hs-cTnI trajectories during the immediate peripartum period and supports delivery as a physiologic cardiovascular “stress test.” PEC is associated with disproportionate myocardial stress compared with normotensive pregnancies, with HTN demonstrating intermediate changes.
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Li et al. (2026) conducted a cohort in Hypertensive disorders of pregnancy (preeclampsia, chronic or gestational hypertension) vs normotensive pregnancy (n=609). Hypertensive disorders of pregnancy (preeclampsia and chronic or gestational hypertension) vs. Normotensive controls was evaluated on Log10-transformed high-sensitivity cardiac troponin I (hs-cTnI) concentrations and peripartum temporal slopes within ±48 hours of delivery (β = 0.266 (PEC vs NC); β = 0.160 (PEC vs HTN); β = 0.107 (HTN vs NC), p=<0.001).
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