Women with PCOS Are at Increased Risk of Major CV Events

Pavankumar Kamat


June 15, 2021


  • Young women with polycystic ovary syndrome (PCOS) had an increased risk of major adverse cardiovascular events (MACE), whether as a composite outcome (myocardial infarction [MI], angina and revascularisation) or as individual outcomes.

  • Weight gain, type 2 diabetes mellitus (T2DM) and social deprivation increased the risk of progression to MACE.

Why this matters

  • International PCOS guidelines recommend assessment of cardiovascular (CV) risk factors and global CV disease risk as a part of long-term patient management.

Study design

  • This retrospective cohort study included 174,660 women with PCOS who were matched (1:1) with control participants, identified from the UK Clinical Practice Research Datalink (1998-2017).

  • Primary outcome: MACE (composite of MI, stroke, angina and revascularisation) and CV mortality.

  • Secondary outcomes: individual components of MACEs.

  • Funding: None disclosed.

Key results

  • Crude incidence rates of MACE, MI, stroke, angina, revascularisation and CV mortality were respectively:

    • 82.7, 22.7, 27.4, 32.8, 10.5 and 6.97 per 100,000 patient-years for women with PCOS; and

    • 64.3, 15.9, 25.7, 19.8, 7.13 and 7.75 per 100,000 patient-years for control participants.

  • In the adjusted Cox proportional hazard models:

    • PCOS vs control group had an increased risk of (adjusted HR [aHR]; 95% CI):

      • MACE (1.26; 1.13-1.41; P<.001);

      • MI (1.38; 1.11-1.72; P=.004);

      • angina (1.60; 1.32-1.94; P<.001); and

      • revascularisation (1.50; 1.08-2.07; P=.015).

    • The risk of progression to MACE increased with (aHR; 95% CI):

      • weight gain (1.01; 1.00-1.01; P<.001);

      • prior T2DM (2.40; 1.76-3.30; P<.001); and

      • Index of Multiple Deprivation quintile 5 (1.53; 1.11-2.11; P=.012).


  • Observational.


Berni TR, Morgan CL, Rees DA. Women with Polycystic Ovary Syndrome have an increased risk of major cardiovascular events: a population study. J Clin Endocrinol Metab. 2021 Jun 01 [Epub ahead of print]. doi: 10.1210/clinem/dgab392. PMID: 34061968 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: