BP.03.01] EFFECT OF ACETYLSALICYLIC ACID ON THE MARKERS OF ENDOTHELIAL CELL DYSFUNCTION IN WOMEN WITH GESTATIONAL HYPERTENSION

Abstract

Objective: The target organ of preeclampsia (PE) is the maternal endothelium. Clinical manifestations are associated with its dysfunction. A case control study was designed to analyze markers of endothelial dysfunction in women with gestational hypertension (GH), preeclamptic women and to compare these levels to the disease state as well as investigate if acetylsalicylic acid (ASA) can influence the endothelial function in women with GH. Design and method: 64 pregnant women with gestational hypertension (GH) (group A), 50 healthy pregnant women (group B) and 45 non-pregnant women (control group C) were enrolled. Exclusion criteria were chronic hypertension, diabetes mellitus,renal disease and antiphospholipid syndrome. Levels of vonWillebrand factor, soluble adhesion molecules-intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1), were compared in all groups. Groups were matched. Low dose (80 mg q.d.) of ASA was prescribed in group A at the time of the diagnosis of GH. Levels of vWF, ICAM-1, VCAM-1 were measured 60 days after ASA began. Multivariate logistic regression models were used. Results: ICAM-1 and VCAM-1 were significantly elevated in women with GH compared to group B and C (296 ± 86,222 ± 79 and 219 ± 89 ng/ml-p < 0.005, 633 ± 101 – 505 ± 87 and 489 ± 98 ng/ml, p = 0.02), whereas vWF was not associated. Eleven women (group A) and 3 (groupB), developed preeclampsia. vWF, VCAM-1 and ICAM-1 levels were significantly higher in preeclamptic patients than in GH women (172% vs 129%, 784 ± 82 vs. 633 ± 109 ng/mL, p < 0.05 and 405 ± 67 vs. 296 ± 57 ng/mL, p < 0.05, respectively). Multivariate logistic regression model showed that levels of ICAM-1, VCAM-1 and vWF have a significant influence on the occurrence of PE (p = 0.04, p = 0.05 and p = 0.006, respectively). VCAM-1, ICAM-1 were significantly lower after ASA was prescribed in group A (633 ± 101 ng/ml vs 410 ± 116 –p < 0.005 and 296 ± 86 vs 188 ± 76 ng/ml, p < 0.005) but not for group B and C. Conclusions: Our data indicate that vWF,VCAM-1 and ICAM-1 levels were significantly higher in preeclamptic patients and are correlated with the development of PE. These data suggest that these molecules may be sensitive inflammatory biomarkers for preeclampsia. The use of ASA reduces adhesion molecules levels in women with gestational hypertension.