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American Heart Association

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Final ID: MDP387

Cardiovascular And Obstetrical Outcomes In Women With Premature Coronary Artery Disease

Abstract Body (Do not enter title and authors here): Background: Premature coronary artery disease (CAD) is increasing, especially in young women. There is currently no data regarding the cardiovascular and obstetrical risk of pregnancy in patients with premature CAD.

Objective: This study aims to describe the cardiovascular, obstetrical and fetal outcomes in pregnant patients with premature CAD.

Methods: Using the AFIJI cohort of individuals with premature CAD (Appraisal of risk Factors in young Ischemic patients Justifying aggressive Intervention), we compared the cardiovascular outcomes of women aged < 40 years-old who experienced pregnancy versus those who did not. Major adverse cardiovascular events (MACE) including death, myocardial infarction, ischemic stroke, or unplanned revascularization were analyzed using a Cox model with pregnancy as a time-dependent variable. A secondary analysis described obstetrical and fetal outcomes in pregnant women with premature CAD vs. pregnant women of the French National maternal and fetal cohort (n=11992).

Results: Among women with premature CAD in the AFIJI cohort (N = 120), 50 were aged < 40 years among whom 24 experienced pregnancy. Aspirin was the only treatment continued during pregnancy. We observed an association between pregnancy and an increased risk of cardiovascular events (aHR 3.87, IC95% 1.41-10.63, p < 0.01) adjusted for age and tobacco use. When comparing with the French National database, pregnant women with premature CAD had higher rates of preeclampsia (20.8% vs. 2.3%), pregnancy-induced hypertension (37.5% vs. 2%), threat of premature birth (20.8% vs. 4.8%), postpartum hemorrhage (12.5% vs. 3%) and fetal death (8.7% vs. 0.8%).

Conclusion: Pregnancy in women with premature coronary artery disease is associated with a higher risk of major adverse cardiovascular events and significant more obstetrical complications. These findings highlight the need for careful monitoring and management of pregnant patients with a prior history of CAD to mitigate these risks.
  • Mikou, Meryem  ( Sorbonne Université , Paris , France )
  • Zeitouni, Michel  ( Sorbonne Université , Paris , France )
  • Procopi, Niki  ( Sorbonne Université , Paris , France )
  • Charleux, Pierre  ( Sorbonne Université , Paris , France )
  • Rahoual, Ghilas  ( Sorbonne Université , Paris , France )
  • Kerneis, Mathieu  ( Sorbonne Université , Paris , France )
  • Silvain, Johanne  ( Sorbonne University - APHP , Paris , Texas , United States )
  • Legrand, Lise  ( Sorbonne Université , Paris , France )
  • Nizard, Jacky  ( Sorbonne Université , Paris , France )
  • Montalescot, Gilles  ( Sorbonne Université , Paris , France )
  • Author Disclosures:
    Meryem MIKOU: DO NOT have relevant financial relationships | Michel Zeitouni: DO NOT have relevant financial relationships | Niki PROCOPI: No Answer | Pierre CHARLEUX: DO NOT have relevant financial relationships | Ghilas Rahoual: DO NOT have relevant financial relationships | Mathieu Kerneis: No Answer | Johanne Silvain: DO NOT have relevant financial relationships | Lise Legrand: No Answer | Jacky Nizard: No Answer | Gilles Montalescot: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):Abbott : research or educational grant to the institution and consulting or lecture fees:Active (exists now) ; Other (please indicate in the box next to the company name):Terumo : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):SMT : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):Pfizer:Active (exists now) ; Other (please indicate in the box next to the company name):Novo Nordisk : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):Lilly:Past (completed) ; Other (please indicate in the box next to the company name):Idorsia:Active (exists now) ; Other (please indicate in the box next to the company name):Hexacath:Past (completed) ; Other (please indicate in the box next to the company name):CSL Behring : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):Celecor : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):Boehringer Ingelheim : research or educational grant to the institution and consulting or lecture fees:Active (exists now) ; Other (please indicate in the box next to the company name):BMS : research or educational grant to the institution and consulting or lecture fees:Active (exists now) ; Other (please indicate in the box next to the company name):Bayer : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):AstraZeneca : research or educational grant to the institution and consulting or lecture fees:Past (completed) ; Other (please indicate in the box next to the company name):Amgen : research or educational grant to the institution and consulting or lecture fees:Past (completed)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Ischemic Heart Disease and Women

Saturday, 11/16/2024 , 09:30AM - 10:55AM

Moderated Digital Poster Session

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Mineralocorticoid receptor antagonist in patients with acute myocardial infarction: An updated systematic review and meta-analysis of randomized trials

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Pre-Hospital Antiplatelet Therapy In Patients With Out-Of-Hospital Cardiac Arrest Suspected Of Acute Coronary Syndrome

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