ASSOCIATION BETWEEN POLYCYSTIC OVARIES AND EXTENT OF CORONARY-ARTERY DISEASE IN WOMEN HAVING CARDIAC-CATHETERIZATION

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.