{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:27:03Z","timestamp":1792686423736,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Endothelial dysfunction represents a key driver in the development of preeclampsia. The Endothelial Activation and Stress Index (EASIX) is a validated predictor of endothelial\u2010related complications in diverse clinical settings beyond obstetrics. Therefore, we aimed to assess the predictive performance of EASIX for adverse maternal and perinatal outcomes in pregnancies with preeclampsia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">This retrospective study analyzed data from 986 patients with preeclampsia who delivered at Heidelberg University Hospital between 2017 and 2022. The primary end points were adverse maternal (death; kidney failure; pulmonary edema; eclampsia; disseminated intravascular coagulation; hemorrhage; cerebrovascular event; and hemolysis, elevated liver enzymes, low platelets syndrome); and perinatal events (death, stillbirth, preterm delivery, placental abruption, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis). EASIX was calculated as a product of lactate dehydrogenase and creatinine, both divided by platelet counts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Five hundred forty\u2010two patients were eligible for the analysis. EASIX was significantly elevated in patients with a maternal adverse event (1.41\u00b10.86 versus 0.87\u00b10.5,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.0001) or perinatal adverse event (1.05\u00b10.65 versus 0.93\u00b10.59,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.046) compared with patients without an adverse event. EASIX was independently associated with adverse maternal (adjusted odds ratio [aOR], 2.90 [2.00\u20134.19]) and perinatal events (aOR, 2.02 [1.21\u20133.39]). These associations were emphasized when stratifying for early\u2010onset preeclampsia. EASIX levels of the highest tertile were associated with the shortest remaining time to delivery (adjusted hazard ratio, 2.10 [1.66\u20132.66]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our findings underline EASIX as an easily available predictive marker of the risk of maternal and perinatal adverse outcomes in patients with preeclampsia. We propose that EASIX may be useful to stratify the individual risk of adverse events, especially in patients with early\u2010onset preeclampsia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.041059","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T12:01:45Z","timestamp":1752753705000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Endothelial Activation and Stress Index Is Associated With Adverse Maternal and Perinatal Outcomes in Preeclampsia"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-3872","authenticated-orcid":false,"given":"Anna S.","family":"Scholz","sequence":"first","affiliation":[{"name":"University Hospital Heidelberg","place":["Heidelberg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel","family":"Kussner","sequence":"additional","affiliation":[{"name":"University Hospital Heidelberg","place":["Heidelberg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Els\u00e4sser","sequence":"additional","affiliation":[{"name":"University Hospital Heidelberg","place":["Heidelberg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0387-1640","authenticated-orcid":false,"given":"Thomas","family":"Luft","sequence":"additional","affiliation":[{"name":"University Hospital Heidelberg","place":["Heidelberg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Wallwiener","sequence":"additional","affiliation":[{"name":"University Hospital Halle (Saale)","place":["Halle, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7649-4914","authenticated-orcid":false,"given":"Alexandra","family":"von Au","sequence":"additional","affiliation":[{"name":"University Hospital 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