Cardiovascular Risk after Preeclampsia - The CRISP study

先兆子痫后的心血管风险 - CRISP 研究

• 批准号: 9769190
• 负责人: LISA Danielle LEVINE
• 金额: $ 74.01万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769190
• 关键词: Address; Affect; African American; American Heart Association; Biological Markers; Blood; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic; Clinical; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Cross-Sectional Studies; Development; Diabetes Mellitus; Diagnosis; Disease; Dyslipidemias; Early Intervention; Echocardiography; Enrollment; Epidemiologist; Event; Exposure to; Feasibility Studies; Future; Goals; High Prevalence; High Risk Woman; Hypertension; Individual; Institution; Knowledge; Maternal Mortality; Maternal-fetal medicine; Metabolic syndrome; Metadata; Morbidity - disease rate; Phenotype; Physiologic pulse; Population; Positioning Attribute; Pre-Eclampsia; Pregnancy; Prevalence; Prospective Studies; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Smoking; Specialist; Telephone; Therapeutic; Time; Troponin; United States; Vascular Diseases; Visit; Woman; Women' s Group; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; care seeking; case control; cohort; high risk; maternal morbidity; mortality; multidisciplinary; personalized care; study population

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is responsible for the annual death of 8.6 million women worldwide and disproportionally affects African American women. Preeclampsia (PEC) affects 3-8% of all pregnancies and is now recognized by the American Heart Association as a potent independent risk factor for CVD. The increased cardiovascular (CV) risk in women with a remote history of PEC is posited to be from the vascular dysfunction that is the hallmark feature of the disease. The development of CVD typically occurs 20-30 years after the exposure to PEC. However, there is a paucity of research investigating the presence of cardiac risk factors in the decade after exposure to PEC – an intermediate time period between the development of PEC disease and overt CVD, when women are young (30-40's) and might not otherwise be seeking care. Our overarching goal is to understand how a history of PEC modifies a woman's long-term CV health. The first step in this goal is to evaluate whether there are risk factors that identify a woman previously exposed to PEC as high risk for CVD, prior to an overt CV event in order to target early intervention and therapeutic strategies. The fundamental premise of our proposal is that women with a history of PEC will have a higher prevalence of traditional risk factors for CVD and a higher prevalence of an intermediate CV phenotype compared to women without a history of PEC. Women from this study will be followed long-term in order to correlate these risk factors with future CV events. We are uniquely positioned to address this important clinical question. We have a group of women with (n=441) and without PEC (n=591) that were previously enrolled in a prospective study conducted at our institution from 2005-2007. An exceptional advantage to this cohort is that cases and controls were evaluated and well-phenotyped at the time of enrollment by specialized Obstetricians, allowing us to have limited bias regarding initial diagnosis of PEC as well as the ability to control for a large amount of metadata that was collected at the time of enrollment. Adding to the richness of this cohort, more than 75% of these women are African American, providing a unique opportunity to study a high risk yet typically understudied population, in whom PEC and CVD are both more prevalent and more severe. This cohort will serve as the study population for our current proposal. We have a multidisciplinary team of obstetricians, cardiologists, vascular researchers and epidemiologists and are well poised to complete the study given our expertise and prior collaboration. Together, in a feasibility study of 150 women, we demonstrated that 57% of women from the original study, now 10 (+/-1) years from their initial exposure to PEC, can be contacted, agree to participate and present for a study visit. Completion of this study will address significant gaps in knowledge regarding the association between PEC and CVD.

项目摘要/摘要 心血管疾病（CVD）负责全球860万妇女死亡 不成比例地影响非洲裔美国妇女。 Precmams（PEC）影响所有怀孕的3-8％，IS 现在，美国心脏协会被认为是CVD的潜在独立危险因素。增加 具有PEC遥远病史的女性的心血管（简历）风险分配为血管功能障碍 那是该疾病的标志性特征。 CVD的发展通常发生在暴露于PEC的20 - 30年后。但是，有一个 暴露于PEC后的十年中研究心脏危险因素的存在的匮乏 - 妇女年轻时，PEC疾病与明显CVD的发展之间的中​​间时间段 （30-40），否则可能不会寻求护理。我们的总体目标是了解PEC的历史如何 修改女性的长期简历健康。该目标的第一步是评估是否存在风险因素 在公开的简历事件之前，将以前暴露于PEC的女性确定为CVD的高风险 针对早期干预和治疗策略。我们建议的基本前提是 具有PEC史的妇女将对CVD和A的传统风险因素的患病率更高 与没有PEC史的女性相比，中间CV表型的患病率更高。 这项研究的妇女将长期遵循，以将这些危险因素与未来的简历事件相关联。 我们在解决这个重要的临床问题方面处于独特状态。我们有一群女人 （n = 441）且没有PEC（n = 591），这些（n = 591）先前已在我们的前瞻性研究中注册 2005年至2007年的机构。该队列的一个特殊优势是评估了病例和对照 并在专业产科医生入学时进行了良好的型号，使我们的偏见有限 有关PEC的初始诊断以及控制大量元数据的能力 在入学时收集。除了这个队列的丰富性，这些女性中有75％以上是 非裔美国人，提供了一个独特的机会来研究高风险，但通常了解人口， PEC和CVD都更加普遍，更严重。该队列将充当研究人群 我们有一个多学科的产科医生，心脏病学家，血管研究人员 鉴于我们的专业知识和先前的合作，并且已经有毒了，并且在研究中有众多的中毒。 在一项对150名女性的可行性研究中，我们证明了57％的原始研究女性， 现在，可以联系初次接触PEC的10（+/- 1）年，可以联系，同意参加并出席 研究访问。这项研究的完成将解决有关协会知识的巨大差距 在PEC和CVD之间。