Abstract 10005: Pregnancy Complications Are Associated With Premature Coronary Artery Disease - Linking Three South Australian Cohorts

Abstract

Introduction: There is increasing evidence that women who experience placenta-mediated pregnancy complications and gestational diabetes mellitus (GDM) are more likely to develop coronary artery disease (CAD) at a younger age. This is the first study to assess the relationship between pregnancy complications and premature coronary artery disease (PCAD) in Australian women. Hypothesis: We hypothesized that there is an association between placenta-mediated pregnancy complications, GDM and risk of CAD prior to 60 years of age. Methods: The research project involved a data linkage approach merging three databases of South Australian cohorts by employing a retrospective, age-matched case-control study design. Cases (n=721) were ascertained from Coronary Angiogram Database of South Australia (CADOSA). Women <60 years from CADOSA were linked to South Australian Perinatal Statistics Collection (SAPSC) to determine their pregnancy outcomes. Controls (n=194) were ascertained from North West Adelaide Health Study (NWAHS) and comprised of women who were healthy or had health conditions other than CAD, age-matched to CADOSA (+/- 5 years) and linked to SAPSC to determine their pregnancy outcomes. PCAD was defined as > 50% stenosis in one or more coronary arteries at coronary angiography. Results: Women who were diagnosed with PCAD were more likely to have experienced a placenta-mediated pregnancy complication, previous miscarriage, asthma or anaemia and/or have risk factors for CAD including pre-existing diabetes (I & II), active smoking and obesity during pregnancy compared to women without a history of CAD as shown in the table below (p < 0.05). GDM was not associated with PCAD in these cohorts. Conclusion: Women diagnosed with PCAD have conventional CVD risk factors and some that are uniquely related to their pregnancy. These clinical events may be considered novel risk factors for future PCAD and require attention in contemporary preventative cardiology practice.