OP 20 Increased classical atherosclerotic risk factors in elderly women with decidual acute atherosis

Abstract

Introduction Uteroplacental acute atherosis is a specific arterial lesion of pregnancy resembling early stages of atherosclerosis. Acute atherosis is frequent in pregnancies complicated by preeclampsia, which is associated with increased long-term maternal risk of atherosclerotic cardiovascular disease (CVD). Objectives We investigated if acute atherosis of the decidua basalis in pregnant women is associated with traditional risk factors for cardiovascular disease, including hypertension, hyperlipidemia, glucose intolerance, elevated CRP, age during pregnancy and prepregnancy body mass index. Materials and methods Women delivered by elective cesarean section ( n = 237; healthy pregnancies n = 94, preeclampsia n = 87, pregestational diabetes and gestational diabetes n = 39, diabetes with preeclampsia n = 17)) provided blood samples prior to caesarean section (cs) together with uteroplacental (decidua) tissue (by vacuum suction at cs) for acute atherosis diagnosis by a validated immunohistochemistry approach. Statistical analyses were performed with Mann–Whitney test. Results We found no associations between acute atherosis and traditional CV biomarkers within the groups of women with normotensive pregnancies, preeclampsia, diabetes or diabetes superimposed with preeclampsia. However, the oldest patient age quartile (36–43 years old) with acute atherosis had significantly increased levels of Low Density Lipoprotein and ApolipoproteinB (both p Acute atherosis was associated with elevated median early pregnancy systolic blood pressure ( p = 0.01) in the total cohort, but likely due to a large proportion of women with acute atherosis having preeclampsia (62.7%). Conclusion As increased levels of LDL and Apolipoprotein B are key events in the initiation of early atherosclerotic lesions, our results may point towards similar mechanisms in development of acute atherosis and early atherosclerotic lesions in the oldest age quartile of pregnancy.