Increased thrombin generation in women with a history of preeclampsia.
BACKGROUND
Women with a history of preeclampsia have an increased risk for cardiovascular disease in later life. We evaluated thrombogenic characteristics of women with a previous history of preeclampsia, expressed in levels of thrombin generation, number of microparticles and related to menstrual cycle and endothelial function, measured as flow-mediated dilatation.


METHODS
We included 18 primipara women with a history of preeclampsia and 17 healthy primipara controls, 15 (+/-3) months after the index pregnancy. Thrombin generation was measured by tissue factor triggered assay, microparticle levels were measured by flow cytometry and the endothelial function was previously examined by measuring flow-mediated dilatation by high-resolution ultrasound, during follicular and luteal phases of the menstrual cycle.


RESULTS
Women with previous preeclampsia produced more total amount of thrombin as calculated from thrombin max, thrombin potential and max slope levels p<0.05, 0.01 and 0.01 respectively. Platelet derived microparticle levels were higher in women with a history of preeclampsia, p=0.07. Flow-mediated dilatation was significantly decreased in comparison to healthy controls (p<0.0001). There were no variation in levels of thrombin, microparticles and flow-mediated dilatation during the menstrual phases.


CONCLUSIONS
Women with a history of preeclampsia show signs of hypercoagulability as indicated by higher thrombin generation and higher platelet derived microparticle levels. Since these women were investigated more than one year after delivery, these results may be indicative of an increased risk of cardiovascular events later in life.
Rafik Hamad
R
R
Department of Woman and Child Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, 171 76 Stockholm, Sweden. rangeen.rafik-hamad@karolinska.se
Curvers
J
J
Berntorp
E
E
Eriksson
Mj
M
Bremme
K
K
D000328:Adult; D001792:Blood Platelets / Q000166:cytology*; D004727:Endothelium / Q000098:blood supply* / Q000378:metabolism; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood / Q000378:metabolism; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D013917:Thrombin / Q000378:metabolism*; D014664:Vasodilation
D013917:Thrombin