Shaw LJ et al. (2008) Post-menopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health–National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE). J Clin Endocrinol Metab [doi:10.1210/jc.2007-0425]

Women with polycystic ovary syndrome (PCOS) have several cardiovascular risk factors, including excess androgens, although studies have failed to demonstrate a definitive association between PCOS and risk of cardiovascular disease. Shaw and colleagues investigated this relationship in a group of postmenopausal women enrolled in the Women's Ischemia Syndrome Evaluation (WISE) study.

The authors identified 390 postmenopausal women who were not receiving hormone therapy or using oral contraceptives. Of these, 102 women had clinical features of PCOS, including hyperandrogenemia and a history of irregular menses. The primary end point was time to cardiovascular events.

Women with PCOS were more likely to have diabetes (P = 0.022), the metabolic syndrome (P = 0.001), increased angiographic coronary artery disease (P = 0.044) and obesity (P = 0.006) than women without PCOS. During 6 years' follow-up, a total of 55 cardiovascular events (25 cardiovascular-related deaths and 30 nonfatal myocardial infarctions) were reported. Compared with women without clinical features of PCOS, women with PCOS had a significantly raised risk of cardiovascular events (hazard ratio 3.3, 95% CI 1.8–5.9, P <0.0001) and their 5-year cardiovascular-event-free survival was significantly reduced (78.9% versus 88.7%, P = 0.006).

The authors conclude that treatment targeted at improving coronary risk factors in postmenopausal women with clinical features of PCOS might help to reduce the incidence of cardiovascular events.