Diabetes and cardiovascular events in women with polycystic ovary syndrome: a 20-year retrospective cohort study

Objective Women with polycystic ovary syndrome (PCOS) are potentially at increased risk of cardiovascular (CV) diseases due to well-established risk factors, including insulin resistance, obesity and type 2 diabetes mellitus (T2DM). However, data showing excess CV events in this population are still lacking. We investigated the incidence and prevalence of CV events in a cohort of women with PCOS. Design Retrospective cohort study (total follow-up >12000person-years). Setting Leicester, Leicestershire and Rutland (Total Female population of 434859), UK. Participants Two thousand three hundred and one women with PCOS (mean age=29 center dot 6years) attending a speciality clinic in Leicestershire, UK. Main outcomes measures T2DM, myocardial infarction (MI), angina, heart failure (HF), stroke and CV-related death. Results Incidence of T2DM, MI, angina, HF, stroke and CV death was respectively 3 center dot 6, 0 center dot 8, 1 center dot 0, 0 center dot 3, 0 center dot 0 and 0 center dot 4 per 1000person-years. At the end of follow-up, the prevalence of MI in the age groups 4554, 5564 and >65years was 1 center dot 9%, 6 center dot 0% and 27 center dot 3% and of angina was 2 center dot 6%, 6 center dot 0% and 27 center dot 3%, respectively. Age-group-specific odds ratios for the prevalence of MI and angina compared to the local female population ranged between 2 center dot 6 (95% CI: 1 center dot 06 center dot 3) and 12 center dot 9 (CI: 3 center dot 448 center dot 6) with the highest ratio being for MI in the group >65years old. Age, history of hypertension and smoking had significant correlations with CV outcomes in the PCOS patients. Conclusion We have shown a high incidence and age-group-specific prevalence of T2DM, MI and angina in the women with PCOS, with over a quarter having had MI or angina in those >65years. These findings should be considered in the treatment strategies and long-term planning for women with PCOS.