Endocrine Abstracts

Introduction: Women with PCOS share the underlying pathology of insulin resistance with diabetes, metabolic syndrome and have increased prevalence of obesity. Despite these well established risk factors data on long term cardiovascular outcomes are limited and conflicting.

Methodology: Retrospective analysis of a multi-ethnic database of all women with PCOS attending one UK endocrine unit between 1988 and 2009. Cardiovascular (CV) events were identified by anonymised data linkage in a community database containing diagnostic coding from all local hospital admission episodes. Individuals were followed up after their earliest registration time until they had a CV event or censored (death, migration or end of observation). Prevalence of the CV events was compared with the local female population (LFP; n=432506).

Results: 2353 PCOS patients were identified: 64.7% white; 29.1% South Asian. Mean age at the end of observation was 32.8 years (SD 10.9). Cumulative observation period was 17314 person-years with a mean observation of 7.4 years (SD 7.3). There were 49 CV events in PCOS patients; myocardial infarction (MI=16), Stroke (n=1), heart failure (HF=5), angina (n=22) and death (n=5) in 31 patients. Age specific prevalence of MI, and angina in 45–54 year old women with PCOS were significantly higher compared to the LFP (1.9% and 2.5% vs 0.2% and 0.8% respectively; P<0.0001). Prevalence remained significantly higher (P<0.0001) for MI in older age groups. (Table) Cumulative incidence of MI and Angina, were respectively 92.4 and 127.1/ 100,000 person-years (national rate 46 and 25.2 respectively). Age specific cardiovascular mortality was also higher in PCOS group compared to national rates; 33.5 vs 4, 76.2 vs 14 and 171 vs 47 in 35–44, 45–54 and 55–64 age groups respectively.

Prevalence (%) of MI/Angina in PCOS vs LFP

*Yate's corrected Paired Chi-Square P Value <0.0001

Discussion: Women with PCOS have a significantly higher prevalence and incidence of CVD compared to the local and national population. Early preventative lifestyle interventions should be considered in these women.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.