Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Apr;93(4):1276-84.
doi: 10.1210/jc.2007-0425. Epub 2008 Jan 8.

Postmenopausal 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 sponsored Women's Ischemia Syndrome Evaluation

Leslee J Shaw  1 , C Noel Bairey Merz, Ricardo Azziz, Frank Z Stanczyk, George Sopko, Glenn D Braunstein, Sheryl F Kelsey, Kevin E Kip, Rhonda M Cooper-Dehoff, B Delia Johnson, Viola Vaccarino, Steven E Reis, Vera Bittner, T Keta Hodgson, William Rogers, Carl J Pepine
Affiliations

Postmenopausal 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 sponsored Women's Ischemia Syndrome Evaluation

Leslee J Shaw et al. J Clin Endocrinol Metab. 2008 Apr.

Retraction in

  • Withdrawn by author.
    [No authors listed] [No authors listed] J Clin Endocrinol Metab. 2015 Mar;100(3):1206. doi: 10.1210/jc.2014-4415. J Clin Endocrinol Metab. 2015. PMID: 25701302 Free PMC article. No abstract available.

Abstract

Background: Women with polycystic ovary syndrome (PCOS) have a greater clustering of cardiac risk factors. However, the link between PCOS and cardiovascular (CV) disease is incompletely described.

Objective: The aim of this analysis was to evaluate the risk of CV events in 390 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.

Methods: A total of 104 women had clinical features of PCOS defined by a premenopausal history of irregular menses and current biochemical evidence of hyperandrogenemia. Hyperandrogenemia was defined as the top quartile of androstenedione (> or = 701 pg/ml), testosterone (> or = 30.9 ng/dl), or free testosterone (> or = 4.5 pg/ml). Cox proportional hazard model was fit to estimate CV death or myocardial infarction (n = 55).

Results: Women with clinical features of PCOS were more often diabetic (P < 0.0001), obese (P = 0.005), had the metabolic syndrome (P < 0.0001), and had more angiographic coronary artery disease (CAD) (P = 0.04) compared to women without clinical features of PCOS. Cumulative 5-yr CV event-free survival was 78.9% for women with clinical features of PCOS (n = 104) vs. 88.7% for women without clinical features of PCOS (n = 286) (P = 0.006). PCOS remained a significant predictor (P < 0.01) in prognostic models including diabetes, waist circumference, hypertension, and angiographic CAD as covariates.

Conclusion: Among postmenopausal women evaluated for suspected ischemia, clinical features of PCOS are associated with more angiographic CAD and worsening CV event-free survival. Identification of postmenopausal women with clinical features of PCOS may provide an opportunity for risk factor intervention for the prevention of CAD and CV events.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Average Hs-CRP values (95% CI) for women with and without clinical features of PCOS. Hs-CRP data were available in 278 of the 390 postmenopausal women.
Figure 2
Figure 2
Predicted CV event rates by quartile of free testosterone ranging from 8.0 to 15.1% for levels from no more than 1.8 to at least 4.5 pg/ml (P = 0.03).
Figure 3
Figure 3
Cumulative unadjusted CV death or MI free survival in postmenopausal women with or without clinical features of PCOS (P = 0.006).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Khan SS, Nessim S, Gray R, Czer LS, Chaux A, Matloff J 1990 Increased mortality of women in coronary artery bypass surgery: evidence for referral bias. Ann Intern Med 112:561–567 - PubMed
    1. Tofler GH, Stone PH, Muller JE, Willich SN, Davis VG, Poole WK, Strauss HW, Willerson JT, Jaffe AS, Robertson T 1987 Effects of gender and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women. J Am Coll Cardiol 9:473–482 - PubMed
    1. Greenland P, Reicher-Reiss H, Goldbourt U, Behar S 1991 In-hospital and 1-year mortality in 1524 women after myocardial infarction: comparison with 4315 men. Circulation 83:484–491 - PubMed
    1. Bairey Merz N, Bonow RO, Sopko G, Balaban RS, Cannon III RO, Gordon D, Hand MM, Hayes SN, Lewis JF, Long T, Manolio TA, Maseri A, Nabel EG, Desvigne Nickens P, Pepine CJ, Redberg RF, Rossouw JE, Selker HP, Shaw LJ, Waters DD 2004 Women’s ischemic syndrome evaluation: current status and future research directions. A report of the National Heart, Lung and Blood Institute Workshop, October 2–4, 2002, Executive Summary. Circulation 109:805–807 - PubMed
    1. Bairey Merz CN, Shaw LJ, Reis SE, Kelsey SF, Olson M, Johnson BD, Pepine CJ, Mankad S, Sharaf BL, Rogers WJ, Pohost GM, Sopko G, for the WISE Investigators 2006 Ischemic heart disease in women: Insights from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE) study. Part II: The role of micro- and macro-vascular disease affecting gender differences in presentation, diagnosis, and outcome. J Am Coll Cardiol 47:S21–S29 - PubMed

Publication types