Cardiovascular Events Associated with PCOS Diagnosis in Large Longitudinal Cohort

Cherlin T , PhD (1), Morse C, PT, DPT, MSA (2), Lee ITL , MD (3), Dokras A, MD, PhD (3), Verma SS, PhD (1) 1. Dept. of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 2. Penn Medicine Biobank, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 3. Perelman School of Medicine, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA

Women with polycystic ovarian syndrome (PCOS), the most common endocrine disorder in women of reproductive age, are at risk for cardiometabolic comorbidities. Little information is known about the long-term health risks that are associated with PCOS as many studies do not follow PCOS patients longitudinally. We hypothesize that like obesity and type 2 diabetes (T2D), women with PCOS are at increased risk for developing cardiovascular disease (CVD). We leveraged a large longitudinal cohort from the Penn Medicine electronic health record (EHR), where out of 945,820 women aged 15-50, 22,030 had at least one PCOS diagnosis. We calculated the age-matched relative risk (RR) for women with PCOS diagnosed with comorbidities such as obesity and T2D, as well as six CVD: cardiomyopathy, hypertensive heart disease, thrombotic disease, congestive heart failure, cerebrovascular accident, and ischemic heart disease. We found that 29.3% and 9.1% of women with PCOS were also diagnosed with obesity and T2D respectively, while CVD diagnoses were low (average 1.1%). Consistent with previous findings, we observed that women with PCOS were at increased risk for obesity (RR = 4.09) and T2D (RR = 2.79) compared to age-matched controls. Interestingly, women with PCOS had increased relative risk for being diagnosed with several CVD comorbidities including cardiomyopathy (RR = 1.18), hypertensive heart disease (RR = 1.74), for thrombotic disease (RR = 2.06), and cerebrovascular accident (RR = 1.24). In a large longitudinal cohort of women diagnosed with PCOS, we showed that PCOS is associated with high risk for obesity, T2D, and several CVD, most notably thrombotic disease. These results add support to a model where PCOS is a risk factor for a suite of cardiometabolic diseases. Due to the high prevalence of CVD in women, longitudinal studies are needed to uncover the molecular and genetic pathways underlying disease progression in women with PCOS.