Assessing the intersection of cardiovascular disease, venous thromboembolism, and polycystic ovary syndrome.
BACKGROUND
No study has examined how the relationship between polycystic ovary syndrome (PCOS) and atherosclerotic cardiovascular diseases (aCVD), of ischemic stroke (ISCH), acute myocardial infarction (AMI), and peripheral vascular disease (PAD), differ in the presence of venous thromboembolism (VTE).


METHODS
We performed a cross-sectional analysis using Truven Health Analytics MarketScan® Commercial databases from 2004-2011. The association between women aged 18-64 years with and without PCOS, and aCVD was assessed using VTE-stratified multivariable logistic regression models.


RESULTS
Overall, women with PCOS were more likely to have aCVD, (aOR, 1.27; 95% CI, 1.10-1.46) especially ISCH (aOR, 1.56; 95% CI, 1.30-1.88), than women without PCOS. When stratified by VTE status, women with PCOS and a VTE diagnosis had a decreased odds of having any aCVD (aOR 0.67; 95% CI, 0.46-0.98), and VTE diagnosis more often preceded the occurrence of ISCH and AMI among women with PCOS compared with women without PCOS.


CONCLUSIONS
Overall, women with PCOS were more likely to have aCVD, with stroke being the most prevalent manifestation. Although VTE often occurred before any aCVD, it appeared to have an inverse association with the development of ISCH, AMI, and PAD among women with PCOS, suggesting that aggressively treating VTE or aCVD early may limit the chances of developing the other thrombogenic condition among women with PCOS.
Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-E64, Atlanta, GA 30333, United States. Electronic address: eokoroh@cdc.gov.
Ekwutosi M
EM
Okoroh
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-F74, Atlanta, GA 30333, United States.
Sheree L
SL
Boulet
Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-F72, Atlanta, GA 30333, United States.
Mary G
MG
George
Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS-E64, Atlanta, GA 30333, United States.
W
W
Craig Hooper
D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D020521:Stroke / Q000209:etiology; D054556:Venous Thromboembolism / Q000209:etiology*
Atherosclerosis; Epidemiology; Polycystic ovary syndrome; Stroke; Venous thrombosis