{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:53:48Z","timestamp":1788144828023,"version":"build-2803163510"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,1,9]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Preeclampsia shares numerous risk factors with cardiovascular diseases. Here, we aimed to assess the potential utility of high-sensitivity cardiac troponin I (hs-cTnI) values during pregnancy in predicting preeclampsia occurrence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This study measured hs-cTnI levels in 3721 blood samples of 2245 pregnant women from 4 international, prospective cohorts. Three analytical approaches were used: (1) a cross-sectional analysis of all women using a single blood sample, (2) a longitudinal analysis of hs-cTnI trajectories in women with multiple samples, and (3) analyses of prediction models incorporating hs-cTnI, maternal factors, and the sFlt-1 (soluble fms-like tyrosine kinase 1)\/PlGF (placental growth factor) ratio.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Women with hs-cTnI levels in the upper quarter had higher odds ratios for preeclampsia occurrence compared with women with levels in the lower quarter. Associations were driven by preterm preeclampsia (odds ratio, 5.78 [95% CI, 2.73\u201312.26]) and remained significant when using hs-cTnI as a continuous variable adjusted for confounders. Between-trimester hs-cTnI trajectories were independent of subsequent preeclampsia occurrence. A prediction model incorporating a practical hs-cTnI level of detection cutoff (\u22651.9 pg\/mL) alongside maternal factors provided comparable performance with the sFlt-1\/PlGF ratio. A comprehensive model including sFlt-1\/PlGF, maternal factors, and hs-cTnI provided added value (cross-validated area under the receiver operator characteristic, 0.78 [95% CI, 0.73\u20130.82]) above the sFlt-1\/PlGF ratio alone (cross-validated area under the receiver operator characteristic, 0.70 [95% CI, 0.65\u20130.76];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.027). As assessed by likelihood ratio tests, the addition of hs-cTnI to each prediction model significantly improved the respective prediction model not incorporating hs-cTnI, particularly for preterm preeclampsia. Net reclassification improvement analyses indicated that incorporating hs-cTnI improved risk prediction predominantly by correctly reclassifying women with subsequent preeclampsia occurrence.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>These exploratory findings uncover a potential role for hs-cTnI as a complementary biomarker in the prediction of preeclampsia. After validation in prospective studies, hs-cTnI, alongside maternal factors, may either be considered as a substitute for angiogenic biomarkers in health care systems where they are sparce or unavailable, or as an enhancement to established prediction models using angiogenic markers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.066199","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T05:00:32Z","timestamp":1700456432000},"page":"95-106","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1\/PlGF Ratio"],"prefix":"10.1161","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8240-2270","authenticated-orcid":true,"given":"Lucas","family":"Bacmeister","sequence":"first","affiliation":[{"name":"Clinic for Cardiology and Angiology, University Heart Center Freiburg\u2013Bad Krozingen, Medical Center\u2013University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. Buellesbach, D.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5211-5593","authenticated-orcid":true,"given":"Alina","family":"Go\u00dfling","sequence":"additional","affiliation":[{"name":"Department of Cardiology (A.G., S.B., T.Z.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3632-0042","authenticated-orcid":true,"given":"Annette","family":"Buellesbach","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology and Angiology, University Heart Center Freiburg\u2013Bad Krozingen, Medical Center\u2013University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. Buellesbach, D.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8306-3351","authenticated-orcid":true,"given":"Anna","family":"Birukov","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (A. Birukov)."},{"name":"Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbr\u00fccke, Nuthetal (A. Birukov)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0913-2096","authenticated-orcid":true,"given":"Jenny E.","family":"Myers","sequence":"additional","affiliation":[{"name":"Maternal &amp; Fetal Health Research Centre, Faculty Biology, Medicine &amp; Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan T.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Maternal &amp; Fetal Health Research Centre, Faculty Biology, Medicine &amp; Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy","family":"Lee","sequence":"additional","affiliation":[{"name":"Maternal &amp; Fetal Health Research Centre, Faculty Biology, Medicine &amp; Health, University of Manchester, United Kingdom (J.E.M., S.T.T., S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne S.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital (M.S.A.), University of Southern Denmark, Odense."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5222-2535","authenticated-orcid":true,"given":"Jan S.","family":"Jorgensen","sequence":"additional","affiliation":[{"name":"Institute for Clinical Research, Faculty of Health Sciences (J.S.J.), University of Southern Denmark, Odense."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2546-5464","authenticated-orcid":true,"given":"Anke","family":"Diemert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M.","family":"Blois","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra C.","family":"Arck","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-1164","authenticated-orcid":true,"given":"Kurt","family":"Hecher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine (A.D., S.M.B., P.C.A., K.H.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-8134","authenticated-orcid":true,"given":"Florian","family":"Herse","sequence":"additional","affiliation":[{"name":"Experimental and Clinical Research Center, a cooperation between the Max-Delbr\u00fcck-Center for Molecular Medicine in the Helmholtz Association and the Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (F.H., R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-2362","authenticated-orcid":true,"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology (A.G., S.B., T.Z.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."},{"name":"University Center for Cardiovascular Research (S.B.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany."},{"name":"German Center for Cardiovascular Research, partner site Hamburg\/Kiel\/L\u00fcbeck, Hamburg (S.B., T.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6636-3080","authenticated-orcid":true,"given":"Ralf","family":"Dechend","sequence":"additional","affiliation":[{"name":"Experimental and Clinical Research Center, a cooperation between the Max-Delbr\u00fcck-Center for Molecular Medicine in the Helmholtz Association and the Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany (F.H., R.D.)."},{"name":"HELIOS Clinic Berlin-Buch, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-1956","authenticated-orcid":true,"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology and Angiology, University Heart Center Freiburg\u2013Bad Krozingen, Medical Center\u2013University of Freiburg, Faculty of Medicine, University of Freiburg, Germany (L.B., A. 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