Cardiac biomarkers (natriuretic peptides and troponin) retain their negative predictive value in pregnant individuals with suspected cardiovascular disease.
How should cardiac biomarkers (natriuretic peptides and troponin) be utilized and interpreted in pregnant individuals?
Cardiac biomarkers should not be routinely measured in uncomplicated pregnancies but are valuable for their negative predictive value when cardiovascular disease is suspected.
Cardiac biomarkers are widely used in the nonpregnant population when acute cardiovascular (CV) pathology is suspected; however, the behavior of these biomarkers in the context of pregnancy is less well understood. Pregnant individuals often have symptoms that mimic those of cardiac dysfunction, and complications of pregnancy may include CV disease. This paper will summarize our current knowledge on the use of cardiac biomarkers in pregnancy and provide suggestions on how to use these tools in clinical practice based on the available evidence. Natriuretic peptides and troponin should not be measured routinely in uncomplicated pregnancy, where values should remain low as in the nonpregnant population. In the context of pre-existing or suspected CV disease, these biomarkers retain their negative predictive value. Elevations of both natriuretic peptides and troponin may occur without clear clinical significance in the immediate postpartum period. Elevations of these markers should always prompt further investigation into possible CV pathology.
Sarma et al. (Mon,) conducted a review in Pregnancy with suspected cardiovascular disease. Cardiac biomarkers (natriuretic peptides and troponin) was evaluated. Cardiac biomarkers (natriuretic peptides and troponin) retain their negative predictive value in pregnant individuals with suspected cardiovascular disease.