A more accurate prediction to rule in and rule out pre-eclampsia using the sFlt-1/PlGF ratio and NT-proBNP as biomarkers.

Fecha de publicación: 25/02/2020 Fecha Ahead of Print: 16/11/2019

Autores de IIS La Fe

María Luisa Martínez Triguero

Autor

Participantes ajenos a IIS La Fe

Lafuente-Ganuza P
Lequerica-Fernandez P
Carretero F
Escudero AI
Martinez-Morillo E
Sabria E
Herraiz I
Galindo A
Lopez A
Alvarez FV

Abstract

Background The management of potential pre-eclamptic patients using the soluble FMS-like tyrosine kinase 1 (sFlt-1)/ placental growth factor (PlGF) ratio is characterised by frequent false-positive results. Methods A retrospective cohort study was conducted to identify and validate cut-off values, obtained using a machine learning model, for the sFlt-1/PlGF ratio and NT-proBNP that would be predictive of the absence or presence of early-onset pre-eclampsia (PE) in singleton pregnancies presenting at 24 to 33 + 6 weeks of gestation. Results For the development cohort, we defined two sFlt-1/PlGF ratio cut-off values of 23 and 45 to rule out and rule in early-onset PE at any time between 24 and 33 + 6 weeks of gestation. Using an sFlt-1/PlGF ratio cut-off value of 23, the negative predictive value (NPV) for the development of early-onset PE was 100% (95% confidence interval [CI]: 99.5-100). The positive predictive value (PPV) of an sFlt-1/PlGF ratio 45 for a diagnosis of early-onset PE was 49.5% (95% CI: 45.8-55.6). When an NT-proBNP value 174 was combined with an sFlt-1/PlGF ratio 45, the PPV was 86% (95% CI: 79.2-92.6). In the validation cohort, the negative and positive values were very similar to those found for the development cohort. Conclusions An sFlt-1/PlGF ratio 23 rules out early-onset PE between 24 and 33 + 6 weeks of gestation at any time, with an NPV of 100%. An sFlt-1/PlGF ratio 45 with an NT-proBNP value 174 significantly enhances the probability of developing early-onset PE.

Datos de la publicación

ISSN/ISSNe:: 1434-6621, 1437-4331
Tipo:: Article
Páginas:: 399-407
DOI:: 10.1515/cclm-2019-0939
PubMed:: 31734648
Factor de Impacto:: 0,977 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Lafuente-Ganuza P:: Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
Lequerica-Fernandez P:: Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
Carretero F:: Catedra de Inteligencia Analítica, Universidad de Oviedo, Oviedo, Spain
Escudero AI:: Obstetrics and Gynaecology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
Martinez-Morillo E:: Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
Sabria E:: Obstetrics and Gynaecology Department, Hospital-Residencia Sant Camil, Barcelona, Spain
Herraiz I:: Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain
Galindo A:: Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain
Lopez A:: Clinical Laboratory, University Hospital 12 de Octubre, Madrid, Spain
Martinez-Triguero ML:: Clinical Laboratory, Hospital La Fe, Valencia, Spain
Alvarez FV:: Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain

Department of Biochemistry and Molecular Biology, Universidad de Oviedo, Oviedo, Spain

Keywords

NT-proBNP, placental growth factor (PlGF), pre-eclampsia, soluble FMS-like tyrosine kinase 1 (sFlt-1)

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