Objectives: Evaluation of the cardiovascular (CV) risk in a sample of CV asymptomatic infertile women with polycystic ovary syndrome (PCOS).
Methods: 100 infertile PCOS women older than 30 years (PCOS group) and 50 fertile non-PCOS women (Non-PCOS group) underwent gynecological and laboratory diagnosis. The diagnostic protocol included determination of body mass index (BMI), Homeostasis model assessment of insulin resistance (HOMA-IR) scoring and cardiologic evaluation using echocardiography, estimation of carotid artery intima-media thickness (CIMT), coronary artery calcium (CAC) score using multi slice non-contrast cardiac CT and cardiac risk ratio (CRR). Study outcomes included the incidence of abnormal cardiac risk parameters and determination of the best minimally invasive modality to be used as screening test.
Results: The median values of CRR, CIMT and CAC Agatson score were significantly higher among PCOS women than in Non-PCOS women. Estimated cardiac risk parameters were positively correlated with the level of hyperandrogenemia, BMI, and HOMA-IR score. High CRR was found to be the most important predictor for the risk of atherosclerosis as judged by CIMT and CIMT was the most important predictor for the risk of coronary atherosclerosis as judged by CAC score. Statistical analyses defined high BMI and CIMT as the sensitive significant predictors for high CAC score.
Conclusion: Adult cardiac asymptomatic PCOS women had high cardiovascular risk. Estimation of CRR is non-invasive, cheap and available screening tool and had predictive ability to detect women had high CIMT. CIMT is a minimally invasive predictor for the extent CAC.