High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1/PlGF Ratio
Performance · Preeclampsia, by hs-cTnI quarterResult — go to the resultOdds ratio 5.78 95% CI 2.73–12.26Authors' conclusion
These exploratory findings uncover a potential role for hs-cTnI as a complementary biomarker in the prediction of preeclampsia.
Study context
- Population
- Pregnant women3,721 blood samples
- Participants
- 2,245 women
- Comparison
- High-sensitivity cardiac troponin I (hs-cTnI) upper quarter vs lower quarter; prediction models with vs without hs-cTnI
- Outcome
- Preeclampsia occurrence
Methodological details4 international prospective cohorts, cross-sectional, longitudinal and prediction-model analyses, exploratory
- 4 international prospective cohorts
- Cross-sectional, longitudinal and prediction-model analyses
- Exploratory
Performance
Preeclampsia, by hs-cTnI quarter
Odds ratio
5.78
95% CI 2.73–12.26
Upper quarter hs-cTnIvs Lower quarter hs-cTnI
OR 5.78 (95% CI 2.73–12.26)
As reported in the abstract
Further findings
| Outcome | Comprehensive model | sFlt-1/PlGF ratio alone | P value |
|---|---|---|---|
| Prediction: comprehensive model (sFlt-1/PlGF, maternal factors, hs-cTnI) vs sFlt-1/PlGF ratio alone | P = 0.027 | ||
| Cross-validated AUC (95% CI) | 0.78 (0.73-0.82) | 0.70 (0.65-0.76) |
Between-trimester hs-cTnI trajectories
- Trajectories independent of subsequent preeclampsia
Prediction: hs-cTnI ≥1.9 pg/mL + maternal factors vs sFlt-1/PlGF ratio
- Comparable performance
Added value of hs-cTnI (likelihood ratio tests, NRI)
- Adding hs-cTnI significantly improved each model, particularly for preterm preeclampsia
- NRI: improvement mainly by correctly reclassifying women with subsequent preeclampsia
Original publication
High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1/PlGF Ratio. Circulation. Published 20 November 2023. doi:10.
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