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Variable expression of soluble fms-like tyrosine kinase 1 in patients at high risk for preeclampsia

Objective. To explore angiogenic factor differences in preeclamptic patients according to the absence or presence of underlying vascular disease. Methods. We prospectively compared serum soluble fms-like tyrosine kinase 1 (sFlt1), soluble endoglin, and placental growth factor (PlGF) from 41 normal-risk and 32 high-risk (preexisting conditions) subjects at serial gestational ages. Results. Median sFlt1 was lower at delivery in preeclamptic patients with underlying chronic hypertension and/or chronic proteinuria (5115 pg/ml) compared with normal risk preeclamptic patients (16375 pg/ml). PlGF was consistently low in patients who developed preeclampsia. Conclusions. Effects of sFlt1 may be contextual, varying according to the health or disease state of vascular endothelium.