Women with PCOS Are at Increased Risk of Major CV Events

Takeaway

• Young women with polycystic ovary syndrome (PCOS) had an increased risk of major adverse cardiovascular events (MACE), whether as a composite outcome (myocardial infarction [MI], angina and revascularisation) or as individual outcomes.
• Weight gain, type 2 diabetes mellitus (T2DM) and social deprivation increased the risk of progression to MACE.

Why this matters

• International PCOS guidelines recommend assessment of cardiovascular (CV) risk factors and global CV disease risk as a part of long-term patient management.

Study design

• This retrospective cohort study included 174,660 women with PCOS who were matched (1:1) with control participants, identified from the UK Clinical Practice Research Datalink (1998-2017).
• Primary outcome: MACE (composite of MI, stroke, angina and revascularisation) and CV mortality.
• Secondary outcomes: individual components of MACEs.
• Funding: None disclosed.

Key results

• Crude incidence rates of MACE, MI, stroke, angina, revascularisation and CV mortality were respectively:
  • 82.7, 22.7, 27.4, 32.8, 10.5 and 6.97 per 100,000 patient-years for women with PCOS; and
  • 64.3, 15.9, 25.7, 19.8, 7.13 and 7.75 per 100,000 patient-years for control participants.
• In the adjusted Cox proportional hazard models:
  • PCOS vs control group had an increased risk of (adjusted HR [aHR]; 95% CI):
    • MACE (1.26; 1.13-1.41; P<.001);
    • MI (1.38; 1.11-1.72; P=.004);
    • angina (1.60; 1.32-1.94; P<.001); and
    • revascularisation (1.50; 1.08-2.07; P=.015).
  • The risk of progression to MACE increased with (aHR; 95% CI):
    • weight gain (1.01; 1.00-1.01; P<.001);
    • prior T2DM (2.40; 1.76-3.30; P<.001); and
    • Index of Multiple Deprivation quintile 5 (1.53; 1.11-2.11; P=.012).

Limitations

• Observational.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.