Abstract 4178: Cardiovascular Event-Free Survival in Post-Menopausal Women with Polycystic Ovary Syndrome: Results from the Women’s Ischemia Syndrome Evaluation
Background: Women with polycystic ovary syndrome (PCOS) have a greater frequency and clustering of cardiac risk factors. Despite this, the link between PCOS and cardiovascular disease has not been established.
Objective: This study’s aim was to evaluate cardiovascular (CV) prognosis in women with biochemical and clinical evidence of PCOS in 390 post-menopausal women (not taking exogenous hormone therapy) prospectively enrolled in the NIH-NHLBI sponsored Women’s Ischemia Syndrome Evaluation (WISE).
Methods: PCOS (n=104) was defined by a premenopausal history of irregular menses accompanied by biochemical evidence of hyperandrogenemia. Hyperandrogenemia was defined as the top quartile of either androstenedione ≥701 pg/ml], testosterone (T; ≥30.9 ng/dl), free T (≥4.5 pg/ml), or androgen index (free T /sex hormone binding globulin [SHBG] ≥9.9], or lowest quartile of SHBG (≥30.8 nmol/l). Univariable and multivariable Cox proportional hazard model was used to estimate CV death (CVD) or myocardial infarction (MI) (n=52).
Results: Women with evidence of hyperandrogenemia were more often diabetic (p<0.0001), obese (p=0.005), had the metabolic syndrome (p<0.0001), and experienced menopause at a younger age (p=0.026). Women meeting criteria for PCOS had a 2.6-fold (95% CI=1.5– 4.5) higher risk of CVD or MI (p<0.0001) (see Figure⇓). This relationship was maintained in a risk-adjusted model controlling for diabetes, hypertension, and angiographic coronary disease severity (p=0.001).
Conclusion: Among post-menopausal women undergoing coronary angiography for suspected ischemia, PCOS is associated with worsening cardiovascular event-free survival.