Ma. Birdsall et al., ASSOCIATION BETWEEN POLYCYSTIC OVARIES AND EXTENT OF CORONARY-ARTERY DISEASE IN WOMEN HAVING CARDIAC-CATHETERIZATION, Annals of internal medicine, 126(1), 1997, pp. 32-35
Background: Women with polycystic ovaries have associated risk factors
for coronary artery disease. It is unknown whether women with more ex
tensive coronary artery disease are more likely to have polycystic ova
ries. Objective: To determine whether women who have more extensive co
ronary 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 Auckl
and, New Zealand, during a 2-year period. Patients: 143 women 60 years
of age or younger who had had coronary angiography. Women who had pre
viously had bilateral oophorectomy were excluded. Measurements: The ex
tent of coronary artery disease assessed by quantitative angiography w
as 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 resistan
ce and gonadotropin, testosterone, and serum lipid levels were also me
asured. Results: Polycystic ovaries were found in 42% of women and wer
e associated with hirsutism; previous hysterectomy; higher free testos
terone, triglyceride, and C-peptide levels; and lower high-density lip
oprotein cholesterol levels. Women with polycystic ovaries had more ex
tensive coronary artery disease than women with normal ovaries (number
of segments with >50% stenosis, 1.7 [95% CI, 1.1 to 2.3] compared wit
h 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 o
f heart disease (P = 0.022) were predictors of the presence of polycys
tic ovaries. Conclusions: In women having coronary angiography, those
with more extensive coronary artery disease were more likely to have p
olycystic ovaries on ultrasonography than were those with less extensi
ve disease. Visualization of polycystic ovaries by sonography was asso
ciated with distinct metabolic and endocrine abnormalities. Further st
udy is required to evaluate whether surgery or hormone replacement the
rapy can modify the risk.