Women with PCOS at increased risk of cardiovascular events, study finds
UK: A recent study has pointed that young women with polycystic ovary syndrome (PCOS) are at an increased risk of angina, heart attack, and revascularization. Further, the study found type 2 diabetes mellitus (T2DM) and weight to be potentially modifiable risk factors amenable to intervention.
In contrast to morbidity, the researchers found no evidence of increased cardiovascular mortality risk in women with PCOS in the study. The study findings appear in The Journal of Clinical Endocrinology & Metabolism.
PCOS is the most common endocrine condition that affects young women. The condition is characterized by menstrual disturbance, hyperandrogenism, and subfertility. Previous studies have shown PCOS to be associated with an increased risk of type 2 diabetes.
There is no clarity in the association between PCOS and the risk of cardiovascular events in women, given the low risk of cardiovascular and cerebrovascular events in this young female population. Therefore, there is a need for longer-term population-based studies with a large sample size to further clarify these risks.
Against the above background, D Aled Rees, Cardiff University, Cardiff, UK, and colleagues aimed to establish the relative risk of myocardial infarction (MI), stroke, angina, revascularization, and cardiovascular mortality for women with PCOS.
For this purpose, the researchers extracted data from the Clinical Practice Research Datalink Aurum database. Patients with PCOS were matched to controls in the ratio of 1:1 by age, BMI category, and primary care practice. The primary outcome was the time to major adverse cardiovascular event (MACE); a composite endpoint incorporating MI, stroke, angina, revascularization, and cardiovascular mortality.
Of 219 034 people with a PCOS diagnosis, 174 660 (79.7%) met the eligibility criteria and were matched.
The research yielded the following findings:
- Crude rates of the composite endpoint, MI, stroke, angina, revascularization, and cardiovascular mortality were respectively 82.7, 22.7, 27.4, 32.8, 10.5, and 6.97 per 100 000 patient-years for cases, and 64.3, 15.9, 25.7, 19.8, 7.13, and 7.75 per 100 000 patient-years for controls.
- In adjusted Cox proportional hazard models (CPHMs), the hazard ratios (HRs) were 1.26, 1.38, 1.60, and 1.50 for the composite outcome, MI, angina, and revascularization, respectively.
- In a time-dependent CPHM, weight gain (HR 1.01), prior type 2 diabetes mellitus (T2DM) (HR 2.40), and social deprivation (HR 1.53) increased risk of progression to the composite endpoint.
The risk of incident MI, angina, and revascularization is increased in young women with PCOS. Weight and T2DM are potentially modifiable risk factors amenable to intervention.
Reference:
Thomas R Berni, Christopher L Morgan, D Aled Rees, Women With Polycystic Ovary Syndrome Have an Increased Risk of Major Cardiovascular Events: a Population Study, The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 9, September 2021, Pages e3369–e3380, https://doi.org/10.1210/clinem/dgab392
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