title: Diabetes and cardiovascular events in women with polycystic ovary syndrome: a 20-year retrospective cohort study.
abstract: OBJECTIVE
  Women with polycystic ovary syndrome (PCOS) are potentially at increased risk of cardiovascular (CV) diseases due to well-established risk factors, including insulin resistance, obesity and type 2 diabetes mellitus (T2DM). However, data showing excess CV events in this population are still lacking. We investigated the incidence and prevalence of CV events in a cohort of women with PCOS.
  
  
  METHODS
  Retrospective cohort study (total follow-up >12,000 person-years).
  
  
  METHODS
  Leicester, Leicestershire and Rutland (Total Female population of 434,859), UK.
  
  
  METHODS
  Two thousand three hundred and one women with PCOS (mean age = 29.6 years) attending a speciality clinic in Leicestershire, UK.
  
  
  METHODS
  T2DM, myocardial infarction (MI), angina, heart failure (HF), stroke and CV-related death.
  
  
  RESULTS
  Incidence of T2DM, MI, angina, HF, stroke and CV death was respectively 3.6, 0.8, 1.0, 0.3, 0.0 and 0.4 per 1000 person-years. At the end of follow-up, the prevalence of MI in the age groups 45-54, 55-64 and >65 years was 1.9%, 6.0% and 27.3% and of angina was 2.6%, 6.0% and 27.3%, respectively. Age-group-specific odds ratios for the prevalence of MI and angina compared to the local female population ranged between 2.6 (95% CI: 1.0-6.3) and 12.9 (CI: 3.4-48.6) with the highest ratio being for MI in the group >65 years old. Age, history of hypertension and smoking had significant correlations with CV outcomes in the PCOS patients.
  
  
  CONCLUSIONS
  We have shown a high incidence and age-group-specific prevalence of T2DM, MI and angina in the women with PCOS, with over a quarter having had MI or angina in those >65 years. These findings should be considered in the treatment strategies and long-term planning for women with PCOS.
authors.affiliation: Department of Cardiovascular Sciences, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK. hamidreza.mani@uhl-tr.nhs.uk
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Mani
authors.forename: Miles J
authors.initials: MJ
authors.lastname: Levy
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Morris
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.forename: John
authors.initials: J
authors.lastname: Bankart
authors.forename: Hannah
authors.initials: H
authors.lastname: Blackledge
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Howlett
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology