Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome

C. Noel Bairey Merz, Leslee J. Shaw, Ricardo Azziz, Frank Z. Stanczyk, George Sopko, Glenn D. Braunstein, Sheryl F. Kelsey, Kevin E. Kip, Rhonda M. Cooper-Dehoff, B. Delia Johnson, Viola Vaccarino, Steven E. Reis, Vera Bittner, T. Keta Hodgson, William Rogers, Carl J. Pepine

Research output: Contribution to journalArticle

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Abstract

Background: Women with polycystic ovary syndrome (PCOS) have greater cardiac risk factor clustering but the link with mortality is incompletely described. Objective: 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. Materials and Methods: 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). Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)875-881
Number of pages7
JournalJournal of Women's Health
Volume25
Issue number9
DOIs
StatePublished - Sep 1 2016

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Polycystic Ovary Syndrome
Cardiovascular Diseases
Mortality
Coronary Artery Disease
Testosterone
Ischemia
National Heart, Lung, and Blood Institute (U.S.)
Menstruation
Androstenedione
National Institutes of Health (U.S.)
Waist Circumference
Menopause
Proportional Hazards Models
Cluster Analysis
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Merz, C. N. B., Shaw, L. J., Azziz, R., Stanczyk, F. Z., Sopko, G., Braunstein, G. D., ... Pepine, C. J. (2016). Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome. Journal of Women's Health, 25(9), 875-881. https://doi.org/10.1089/jwh.2015.5441

Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome. / Merz, C. Noel Bairey; Shaw, Leslee J.; Azziz, Ricardo; Stanczyk, Frank Z.; Sopko, George; Braunstein, Glenn D.; Kelsey, Sheryl F.; Kip, Kevin E.; Cooper-Dehoff, Rhonda M.; Johnson, B. Delia; Vaccarino, Viola; Reis, Steven E.; Bittner, Vera; Hodgson, T. Keta; Rogers, William; Pepine, Carl J.

In: Journal of Women's Health, Vol. 25, No. 9, 01.09.2016, p. 875-881.

Research output: Contribution to journalArticle

Merz, CNB, Shaw, LJ, Azziz, R, Stanczyk, FZ, Sopko, G, Braunstein, GD, Kelsey, SF, Kip, KE, Cooper-Dehoff, RM, Johnson, BD, Vaccarino, V, Reis, SE, Bittner, V, Hodgson, TK, Rogers, W & Pepine, CJ 2016, 'Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome', Journal of Women's Health, vol. 25, no. 9, pp. 875-881. https://doi.org/10.1089/jwh.2015.5441
Merz, C. Noel Bairey ; Shaw, Leslee J. ; Azziz, Ricardo ; Stanczyk, Frank Z. ; Sopko, George ; Braunstein, Glenn D. ; Kelsey, Sheryl F. ; Kip, Kevin E. ; Cooper-Dehoff, Rhonda M. ; Johnson, B. Delia ; Vaccarino, Viola ; Reis, Steven E. ; Bittner, Vera ; Hodgson, T. Keta ; Rogers, William ; Pepine, Carl J. / Cardiovascular Disease and 10-Year Mortality in Postmenopausal Women with Clinical Features of Polycystic Ovary Syndrome. In: Journal of Women's Health. 2016 ; Vol. 25, No. 9. pp. 875-881.
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abstract = "Background: Women with polycystic ovary syndrome (PCOS) have greater cardiac risk factor clustering but the link with mortality is incompletely described. Objective: 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. Materials and Methods: 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). Results: 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. Conclusion: 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.",
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AU - Merz, C. Noel Bairey

AU - Shaw, Leslee J.

AU - Azziz, Ricardo

AU - Stanczyk, Frank Z.

AU - Sopko, George

AU - Braunstein, Glenn D.

AU - Kelsey, Sheryl F.

AU - Kip, Kevin E.

AU - Cooper-Dehoff, Rhonda M.

AU - Johnson, B. Delia

AU - Vaccarino, Viola

AU - Reis, Steven E.

AU - Bittner, Vera

AU - Hodgson, T. Keta

AU - Rogers, William

AU - Pepine, Carl J.

PY - 2016/9/1

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N2 - Background: Women with polycystic ovary syndrome (PCOS) have greater cardiac risk factor clustering but the link with mortality is incompletely described. Objective: 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. Materials and Methods: 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). Results: 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. Conclusion: 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.

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