Raised cardiac troponins: Troponin is raised in pre-eclampsia

doi:10.1136/bmj.329.7457.111-a

BMJ 2004;329:111 (10 July), doi:10.1136/bmj.329.7457.111-a

Letter

Raised cardiac troponins

Troponin is raised in pre-eclampsia

The first 100% of the full text of this article appears below.

EDITOR—In their editorial on raised cardiac troponinsAmmann et al omit an important cause of increased troponin concentrationin obstetric medicine—gestational hypertension and pre-eclampsia.¹

Fleming et al showed fivefold higher median values for cardiactroponin I in preeclamptic women than in normotensive pregnantwomen.² These median values were above those which would beindicative of significant myocardial damage. Awareness of thisbecomes important in women with severe pre-eclampsia complicatedby pulmonary oedema, the pathogenesis of which is likely tobe multifactorial related to capillary leak, hypoalbuminaemia,hypertension, and global left ventricular dysfunction. It isalso important as the other commonly used marker of myocardialischaemia, the MB isoenzyme of creatine kinase, is raised inaround a third of normal pregnant women on the first postpartumday after vaginal delivery.³

Adam Morton, endocrinologist and obstetric physician

Mater Hospital, South Brisbane, QLD 4101, Australia amorton@mater.org.au

Competing interests: None declared.

Ammann P, Pfisterer M, Fehr T, Rickli H. Raised cardiac troponins. BMJ 2004;328: 1028-9. (1 May.)[Free Full Text]
Fleming SM, O'Gorman T, Finn J, Grimes H, Daly K, Morrison JJ. Cardiac troponin I in pre-eclampsia and gestational hypertension. Br J Obstet Gynaecol 2000;107: 1417-20.
Leiserowitz GS, Evans AT, Samuels SJ, Omand K, Kost GJ. Creatine kinase and its MB isoenzyme in the third trimester and the peripartum period. J Reprod Med 1992;37: 910-6.[Web of Science][Medline]