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Cited by 87Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsMenopause: Health Impacts and Treatments

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

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Merz, C. Noel Bairey, Shaw, Leslee J., Azziz, Ricardo, Stanczyk, Frank Z., Sopko, George, Braunstein, Glenn D., Kelsey, Sheryl F., Kip, Kevin E. +8 more·2016·Journal of Women's Health
DOI 10.1089/jwh.2015.5441PMC PMC5311460
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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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  • PCOS has been recognized recently as a lifelong disease affecting individuals into the postmenopausal years.

    “PCOS has been recognized recently as a lifelong disease affecting individuals into the postmenopausal years.35, 36, 37, 38, 39”

    From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [39]

    The Discussion (page not available) identifies clinical features of PCOS in postmenopausal women, supporting the point that PCOS-related features are relevant after menopause. But it says those women may or may not have had premenopausal hyperandrogenemia and calls for studies following women with established PCOS through menopause. It therefore does not establish the stronger claim that PCOS has been recognized as a lifelong disease. (LLM, conf=0.87)

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Authors
Merz, C. N. B., Shaw, L. J., Azziz, R., Stanczyk, F. Z., Sopko, G., Braunstein, G. D., Kelsey, S. F., Kip, K. E., Cooper-DeHoff, R. M., Johnson, B. D., Vaccarino, V., Reis, S. E., Bittner, V., Hodgson, T. K., Rogers, W., & Pepine, C. J.
Affiliations
  • Cedars-Sinai Medical Center (US)
  • Emory University (US)
  • Augusta University (US)
  • University of Southern California (US)
  • National Heart, Lung, and Blood Institute (US)
  • University of Pittsburgh (US)
  • Division of Cardiology, Department of Medicine, University of Florida, Gainesville, Florida.
  • University of Florida Health (US)
  • Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
  • University of Alabama at Birmingham (US)
Corresponding author
Merz, C. Noel Bairey
ORCID
Venue
Journal of Women's Health
Publisher
SAGE Publications
Published
2016-09
Volume
25
Issue
9
Pages
875-881
ISSN
  • 1059-7115 (ISSN-L)
  • 1540-9996
  • 1931-843X
DOI
10.1089/jwh.2015.5441
PMC
PMC5311460
OpenAlex
W2414126158
Cited by
87
References
38
Citations by year
2026: 6 · 2025: 5 · 2024: 9 · 2023: 12 · 2022: 4 · 2021: 12 · 2020: 12 · 2019: 8 · 2018: 9 · 2017: 10
FWCI
11.97
Type
journal article
Language
en
Open access
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Journal of Women s Health (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Deutsches Krebsforschungszentrum
  • Society for Women’s Health Research
  • Ladies Hospital Aid Society
  • Cedars-Sinai Medical Center
  • Qmed
  • National Institutes of Health (UL1TR001427, U01-HL649241, UL1TR000124, UL1TR000064, U01-HL649141, N01-HV-68163, MO1-RR00425, N01‐HV‐68164, RR00425, N01‐HV‐68161, N01-HV-68162)
  • National Institute on Aging (N01-HV-68163, T32HL69751, N01-HV-68161, U01HL649241, MO1-RR00425, U01 HL649141, R03AG032631, U0164829, N01-HV-68162, N01-HV-68164)
  • National Heart, Lung, and Blood Institute (N01-HV68162, N01 HV 68161, U01HL649141, U01-64829, N01HV68163, U01 HL649241, N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, T32HL69751, R01HL090957, MO1-RR00425, K23HL105787, N01-HV68164)
  • National Center for Research Resources (T32HL69751, U0164829, U01 HL649141, MO1-RR00425, GCRC grant MO1-RR00425, M01RR000425, U01 HL649241)
  • National Center for Advancing Translational Sciences (Grant UL1TR000124, UL1TR000124 and UL1TR000064)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
polycystic ovary syndrome, postmenopausal women, cardiovascular disease, mortality, coronary artery disease, hyperandrogenemia, androstenedione, free testosterone, smoking, menopause timing, Women's Ischemia Syndrome Evaluation, ischemic heart disease
MeSH terms
Aged, Androstenedione, Cardiovascular Diseases, Female, Humans, Menstruation Disturbances, Middle Aged, Polycystic Ovary Syndrome, Risk Factors, Testosterone, United States, Multivariate Analysis, Proportional Hazards Models, Postmenopause, Kaplan-Meier Estimate

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