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Association between Polycystic Ovaries and Extent of Coronary Artery Disease in Women Having Cardiac Catheterization
Abstract
BACKGROUND: Women with polycystic ovaries have associated risk factors for coronary artery disease. It is unknown whether women with more extensive coronary artery disease are more likely to have polycystic ovaries. OBJECTIVE: To determine whether women who have more extensive coronary artery disease as seen on coronary angiography are more likely to have polycystic ovaries appearing on ultrasonography than are women with less severe coronary disease. DESIGN: Prevalence study of women who had had coronary angiography. SETTING: Women referred for coronary angiography for assessment of chest pain or valvular disease in Auckland, New Zealand, during a 2-year period. PATIENTS: 143 women 60 years of age or younger who had had coronary angiography. Women who had previously had bilateral oophorectomy were excluded. MEASUREMENTS: The extent of coronary artery disease assessed by quantitative angiography was compared with the presence or absence of polycystic ovaries. Pelvic ultrasonography was done without knowledge of the extent of coronary artery disease. Assessment of angiograms was blinded. Insulin resistance and gonadotropin, testosterone, and serum lipid levels were also measured. RESULTS: Polycystic ovaries were found in 42% of women and were associated with hirsutism; previous hysterectomy; higher free testosterone, triglyceride, and C-peptide levels; and lower high-density lipoprotein cholesterol levels. Women with polycystic ovaries had more extensive coronary artery disease than women with normal ovaries (number of segments with > 50% stenosis, 1.7 [95% CI, 1.1 to 2.3] compared with 0.82 [CI, 0.54 to 1.1]; P < 0.01). On logistic regression analysis, the extent of coronary artery disease (P = 0.032) and family history of heart disease (P = 0.022) were predictors of the presence of polycystic ovaries. CONCLUSIONS: In women having coronary angiography, those with more extensive coronary artery disease were more likely to have polycystic ovaries on ultrasonography than were those with less extensive disease. Visualization of polycystic ovaries by sonography was associated with distinct metabolic and endocrine abnormalities. Further study is required to evaluate whether surgery or hormone replacement therapy can modify the risk.
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“In PCOS, other novel CVD risk factors, premature cardiovascular dysfunction and subclinical CVD 29,30,83 have been noted and are related to IR and obesity. 84-89”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [87]
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BackgroundTrakakis, E., Balanika, A. P., Baltas, C. S., Loghis, C., Simeonidis, G., Vaggopoulos, V., Papakonstantinou, O., Gouliamos, A. D., Salamalekis, G., & Kassanos, D. (2008) · Journal of Endocrinological Investigation · doi:10.1007/bf03345639 · Cited by 21
Göde, F., Karagöz, Ç., Posacı, C., Saatli, B., Uysal, D., Seçil, M., & Akdeniz, B. (2010) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-010-1790-9 · Cited by 21
“PCOS increases the risk of cardiovascular diseases and metabolic disorders [16, 17].”
BackgroundÇelik, Ö., Şahin, İ., Çelik, N., Hasçalık, Ş., Keskin, L., Özcan, H., Uçkan, A., & Kosar, F. (2007) · Human Reproduction · doi:10.1093/humrep/dem286 · Cited by 21
“It has been reported that NT-proBNP is more sensitive and specific in being a marker of ventricular dysfunction than the biologically active BNP (Yu et al., 1996; Birdsall et al., 1997; Hunt et al., 1997).”
BackgroundInfluentialHyperandrogenaemia and the ovary
Norman, R. J. (2002) · Molecular and Cellular Endocrinology · doi:10.1016/s0303-7207(02)00062-x · Cited by 21
Cardiovascular Physiology of Androgens and Androgen Testosterone Therapy in Postmenopausal Women
Ling, S., Komesaroff, P. A., & Sudhir, K. (2009) · Endocrine Metabolic & Immune Disorders - Drug Targets · doi:10.2174/187153009787582414 · Cited by 18
“Lower but more sustained exposure to androgen excess in women with polycystic ovary syndrome is associated with more extensive atherosclerosis at coronary angiography [60] but no excess of CVD despite increases in cardiovascular risk factors [61].”
BackgroundInsulin resistance and polycystic ovary syndrome
Ehrmann, D. A. (2002) · Current Diabetes Reports · doi:10.1007/s11892-002-0061-y · Cited by 19
Nahuis, M. J., Oude Lohuis, E. J., Bayram, N., Hompes, P. G. A., Oosterhuis, G. J. E., van der Veen, F., Mol, B. W. J., & van Wely, M. (2014) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.09.004 · Cited by 18
Metadata
- Authors
- Birdsall, M. A., Farquhar, C. M., & White, H. D.
- Affiliations
- University of Auckland (NZ)
- Corresponding author
- Birdsall, Mary A.
- ORCID
- White, Harvey D.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1997-01-01
- Volume
- 126
- Issue
- 1
- Pages
- 32-35
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W1964741472
- Cited by
- 327
- References
- 0
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 2 · 2016: 7 · 2015: 15 · 2014: 2 · 2013: 9 · 2012: 11
- FWCI
- 12.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- polycystic ovary syndrome, coronary artery disease, women, coronary angiography, coronary stenosis extent, hirsutism, free testosterone, insulin resistance, triglycerides, C-peptide, HDL cholesterol, family history of heart disease
- MeSH terms
- Adult, Analysis of Variance, Coronary Disease, Female, Cardiac Catheterization, Humans, Middle Aged, Polycystic Ovary Syndrome, Prospective Studies, Ultrasonography, Coronary Angiography
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