The impact of the polycystic ovarian syndrome (PCOS) on cardiovascular morbidity and death remains unknown. The purpose of this study is to determine the risk of myocardial infarction (MI), stroke, angina, revascularization, and cardiovascular mortality in women with PCOS. The information was obtained from the Clinical Practice Research Datalink Aurum database. Patients with PCOS were matched (1:1) to controls based on age, BMI category, and primary care practice. The key endpoint was the time to a major adverse cardiovascular event (MACE), which was a composite endpoint that included MI, stroke, angina, revascularization, and cardiovascular death. Individual MACE endpoints were secondary outcomes. 174 660 people with PCOS fulfilled the qualifying criteria and were matched out of a total of 219 034 people with the condition. Cases had crude rates of the composite endpoint, MI, stroke, angina, revascularization, and cardiovascular mortality of 82.7, 22.7, 27.4, 32.8, 10.5, and 6.97 per 100 000 patient-years, whereas controls had rates of 64.3, 15.9, 25.7, 19.8, 7.13, and 7.75 per 100 000 patient-years. The hazard ratios (HRs) for the composite outcome, MI, angina, and revascularization were 1.26, 1.38, 1.60, and 1.50, respectively, in adjusted Cox proportional hazard models (CPHMs). Weight gain, previous type 2 diabetes mellitus, and social deprivation all enhanced the likelihood of progression to the composite end goal in a time-dependent CPHM.

Young women with PCOS have an increased risk of MI, angina, and revascularization. Weight and T2DM are potentially controllable risk factors that can be addressed.