Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome.
Women with polycystic ovary syndrome (PCOS) have greater cardiac risk factor clustering but the link with mortality is incompletely described.



To evaluate outcomes in 295 postmenopausal women enrolled in the National Institutes of Health-National Heart, Lung, and Blood Institute (NIH-NHLBI) sponsored Women's Ischemia Syndrome Evaluation (WISE) study according to clinical features of PCOS.



A total of 25/295 (8%) women had clinical features of PCOS defined by a premenopausal history of irregular menses and current biochemical evidence of hyperandrogenemia, defined as the top quartile of androstenedione (≥701 pg/mL), testosterone (≥30.9 ng/dL), or free testosterone (≥4.5 pg/mL). Cox proportional hazard model estimated death (n = 80).



Women with clinical features of PCOS had an earlier menopause (p = 0.01), were more often smokers (p < 0.04), and trended toward more angiographic coronary artery disease (CAD) (p = 0.07) than women without these features. Cumulative 10-year mortality was 28% for women with (n = 25) versus 27% without clinical features of PCOS (n = 270) (p = 0.85). PCOS was not a significant predictor (p = NS) in prognostic models including diabetes, waist circumference, hypertension, and angiographic CAD.



From this longer-term follow up of a relatively small cohort of postmenopausal women with suspected ischemia, the prevalence of PCOS is similar to the general population, and clinical features of PCOS are not associated with CAD or mortality. These findings question whether identification of clinical features of PCOS in postmenopausal women who already have known cardiovascular disease provides any additional opportunity for risk factor intervention.
1 Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute , Cedars-Sinai Medical Center, Los Angeles, California.
C Noel Bairey
CN
Merz
2 Clinical Cardiovascular Research Institute, Emory University , Atlanta, Georgia .
Leslee J
LJ
Shaw
3 Medical College of Georgia , Augusta, Georgia .
Ricardo
R
Azziz
4 University of Southern California , Los Angeles, California.
Frank Z
FZ
Stanczyk
5 National Heart, Lung, and Blood Institute , NIH, Bethesda, Maryland.
George
G
Sopko
6 Department of Medicine, Cedars-Sinai Medical Center , Los Angeles, California.
Glenn D
GD
Braunstein
7 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
Sheryl F
SF
Kelsey
7 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
Kevin E
KE
Kip
8 Division of Cardiology, Department of Medicine, University of Florida , Gainesville, Florida.
Rhonda M
RM
Cooper-DeHoff
7 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
B Delia
BD
Johnson
8 Division of Cardiology, Department of Medicine, University of Florida , Gainesville, Florida.
Viola
V
Vaccarino
9 Cardiovascular Institute, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
Steven E
SE
Reis
10 Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
Vera
V
Bittner
6 Department of Medicine, Cedars-Sinai Medical Center , Los Angeles, California.
T Keta
TK
Hodgson
10 Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
William
W
Rogers
8 Division of Cardiology, Department of Medicine, University of Florida , Gainesville, Florida.
Carl J
CJ
Pepine
D000368:Aged; D000735:Androstenedione / Q000097:blood; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008599:Menstruation Disturbances / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D017698:Postmenopause / Q000097:blood*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013739:Testosterone / Q000097:blood; D014481:United States
D013739:Testosterone; D000735:Androstenedione