title: Cardiovascular outcomes after preeclampsia or eclampsia complicated by myocardial infarction or stroke.
abstract: OBJECTIVE
  To assess the relationship between preeclampsia or eclampsia and stroke, myocardial infarction (MI), subsequent cardiovascular outcomes, and long-term survival.
  
  
  METHODS
  Using the Myocardial Infarction Data Acquisition System in New Jersey (1994-2009), we analyzed cardiovascular outcomes in women with and without preeclampsia or eclampsia and a first MI or stroke but with a hospitalization for a first MI or stroke (analysis 1: MI case group, n=57; MI control group, n=155; stroke case group, n=132; stroke control group, n=379). We also compared these outcomes in women with preeclampsia or eclampsia and a first MI or stroke during pregnancy with women with preeclampsia or eclampsia without MI or stroke during pregnancy (analysis 2: MI case group, n=23; MI control group, n=67; stroke case group, n=90; stroke control group, n=263). A subsequent occurrence of MI, stroke, and cardiovascular death, as well as a combined cardiovascular outcome, was ascertained.
  
  
  RESULTS
  In analysis 1, women with preeclampsia or eclampsia were at significantly lower risk for combined cardiovascular outcome with all deaths (frequency of outcome 16.7%) and with cardiovascular deaths (10.6%) compared with women without preeclampsia or eclampsia after a first stroke (33.8% and 23.5%, respectively). In analysis 2, women with preeclampsia or eclampsia and a first stroke during admission were at significantly higher risk of all death (11.1%) and the combined cardiovascular outcome with all deaths (11.1%) compared with women with preeclampsia or eclampsia without a stroke (1.9% and 2.7%, respectively) during that admission.
  
  
  CONCLUSIONS
  Our study indicates that preeclampsia or eclampsia not complicated by MI or stroke during pregnancy may not confer a very high risk for subsequent MI and stroke in up to 16 years of follow-up. Our data suggest that other known risk factors put women at greater risk for stroke than preeclampsia or eclampsia complicated by a stroke.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics/Gynecology and Reproductive Sciences and the Cardiovascular Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA. gastrimd@umdnj.edu
authors.forename: Mary Downes
authors.initials: MD
authors.lastname: Gastrich
authors.forename: Sampada K
authors.initials: SK
authors.lastname: Gandhi
authors.forename: John
authors.initials: J
authors.lastname: Pantazopoulos
authors.forename: Edith A
authors.initials: EA
authors.lastname: Zang
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cosgrove
authors.forename: Javier
authors.initials: J
authors.lastname: Cabrera
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Sedjro
authors.forename: Gloria
authors.initials: G
authors.lastname: Bachmann
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004461:Eclampsia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D011225:Pre-Eclampsia; D011247:Pregnancy; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis; D055815:Young Adult