Assessment of Cardiac Biomarkers in Pregnant Women with and without Hypertensive Disorders: A Cross-sectional Study

Introduction: Hypertensive Disorders of Pregnancy (HDP) remain a leading cause of maternal and foetal morbidity worldwide. Given the rising burden of cardiovascular morbidity in India, there is a critical need to evaluate specific cardiac biomarkers to identify subclinical cardiac strain in regional clinical settings. Aim: To compare the serum level of cardiac biomarkers in pregnant women with and without hypertensive disorders attending Antenatal Clinic at a Tertiary Care Hospital of Central India. Materials and Methods: The present cross-sectional study was conducted between May 2023 to May 2024 at Hamidia Hospital a Tertiary Care Hospital associated with Gandhi Medical College, Bhopal, Madhya Pradesh, Central India. Total 312 study participants were enrolled and divided into normotensive (n=239), Gestational Hypertension (GH) (n=33) and Preeclampsia (PE) (n=40). The cardiac biomarkers such as Creatine Phosphokinase-MB (CPK-MB), Lactate Dehydrogenase (LDH), Serum Glutamic Oxaloacetic Transaminase (SGOT), Highsensitivity C-Reactive Protein (hsCRP), glucose and creatinine were measured by fully automated biochemistry analyser and Troponin-I and NT-proBNP by Enzyme Linked Immunosorbent Assay (ELISA) method. One-way Analysis of variance (ANOVA) and Chi-square test was used for comparison of data among groups. the p<0.05 was considered as significant level. Results: No significant difference was found in age and Body Mass Index (BMI) among the groups. A significant, stepwise increase was found in the levels of multiple cardiac biomarkers as the severity escalated from GH to PE (p<0.001 for all). Specifically, the median levels of NT-proBNP, a marker of ventricular wall stress, showed a dramatic surge from 29 pg/mL (Normotensive) to 40 pg/mL in GH group and a striking 155 pg/ mL in the PE group. Similarly, Troponin I (myocardial injury) and CPK-MB, SGOT, and LDH (tissue damage) were all significantly elevated in the HDP groups. Conclusion: HDP are associated with a progressive rise in cardiac and tissue injury biomarkers, with the highest levels observed in PE. The marked increase in NT-proBNP highlights significant cardiac stress and supports the potential role of these biomarkers in risk assessment and clinical monitoring. These findings advocate for the integration of specific biomarkers into routine screening to enable early risk stratification and improve maternal-foetal outcomes in HDP.