Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003–2008

Abstract

OBJECTIVE-We sought to determine prevalence and likelihood of venous thromboembolism (VTE) among women with and without polycystic ovary syndrome (PCOS). STUDY DESIGN-We performed a cross-sectional analysis using Thomson Reuters MarketScanCommercial databases for the years 2003 through 2008. The association between VTE and PCOS among women aged 18-45 years was assessed using age-stratified multivariable logistic regression models.RESULTS-Prevalence of VTE per 100,000 was 374.2 for PCOS women and 193.8 for women without PCOS. Compared with women without PCOS, those with PCOS were more likely to have VTE (adjusted odds ratio [aOR] 18-24 years, 3.26; 95% confidence interval [CI], 2.61-4.08; aOR 25-34 years, 2.39; 95% CI, 2.12-2.70; aOR 35-45 years, 2.05; 95% CI, 1.84-2.38). A protective association (odds ratio, 0.8; 95% CI, 0.73-0.98) with oral contraceptive use was noted for PCOS women.CONCLUSION-PCOS might be a predisposing condition for VTE, particularly among women aged 18-24 years. Oral contraceptive use might be protective. Keywordspolycystic ovary syndrome; prevalence; venous thromboembolism Venous thromboembolism (VTE) is a chronic condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Initial presentation might be leg pain, tenderness, shortness of breath, or pleuritic chest pain, or there might be no symptoms. 1 VTE is the third most common cardiovascular disease-after myocardial infarction and stroke-among the general population. 2,3 The overall annual incidence of VTE is estimated © 2012 Mosby, Inc. All rights reserved.Reprints: Ekwutosi M. Okoroh, MD, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E64, Atlanta, GA 30333. Eokoroh@cdc.gov. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The authors report no conflict of interest.Presented orally at the 60th Annual Epidemic Intelligence Service Conference, Atlanta, GA, April 11-15, 2011. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript to be 1-2 per 1000 adults per year. [4][5][6][7] These incident estimates, however, might not represent the entire population because VTE incidence differs by age and race, and slightly by sex. VTE is a multifactorial disease with both inherited and acquired risk factors. In 26-47% of first-time VTE cases, the etiology is unknown 4,5,8 ; a possible predisposing condition not yet assessed is polycystic ovary syndrome (PCOS).PCOS is the most common endocrine disorder affecting women of reproductive age. Estimates of its prevalence vary and range from 4-6%. 9-12 Its exact etiology is unknown, but it is characterized by a heterogeneous presentation of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. 13 PCOS is also associated with insulin-induced elevations of plasminogen activator inhibitor (P...

The Potential Implications of a PCOS Diagnosis on a Woman's Long-Term Health Using Data Linkage

“…Furthermore, our finding of a doubling of the incidence of venous thrombosis among women with PCOS has recently been confirmed in a study in the United States of women with PCOS taking the oral contraceptive pill (OCP) and a 50% increased risk in women with PCOS not taking the OCP (38). An earlier study had demonstrated the increased risk of venous thrombosis for women with PCOS, and reported a potential beneficial effect when a woman with PCOS was commenced on the OCP (39). Furthermore, in line with previous literature (40), we noted an excess of cerebrovascular events and arterial disease in women with PCOS, which is a significant concern considering the young age of this PCOS population, suggesting that intervention to address any coexistent adverse lifestyle features is essential.…”

Contraception and Venous Thromboembolism: Risk Factors and Clinical Considerations

“…Among women aged 18 -24 with PCOS the adjusted odds ratio for VTE was 3.26 (95% CI, 2.61 -4.08) [20]. In another population-based cohort study examining VTE risk among women with PCOS who were not using hormonal contraception the relative risk of VTE compared to non PCOS subjects was 1.…”

National consensus on the management of patients with hyperandrogenism (2016)

“…Доведено, що в пацієнток із СПКЯ ризик венозних тром-боемболічних ускладнень є значно вищим, ніж загалом у популяції [54][55][56]. Так, у масштабному дослідженні за участю 90 тис.…”

“…Так, у масштабному дослідженні за участю 90 тис. пацієнток у США було виявлено, що часто-та венозних тромбоемболій у жінок із СПКЯ на 60% вища, ніж у контрольній групі (відносний ризик 1,6; 95% довірчий інтервал 1,13-2,34) [54]. Поряд із іншими порушеннями об-міну речовин схильність до тромбоутворення при СПКЯ також обумовлена гіперінсулінемією, що стимулює синтез інгібітора активатора плазміногену-1 (маркера тромбозів), який в свою чергу пригнічує фібриноліз [39,57].…”