PCOS a risk factor for arrhythmias

Women with polycystic ovarian syndrome (PCOS) are at an increased long-term risk of arrhythmias and are likely to receive cardiac implantable electronic device (CIED), according to a study.

The study included 26,728 women with PCOS (median age 27.8 years) and 106,912 matched controls from the general population. Women with PCOS had a higher comorbidity burden and pharmacotherapy use compared with controls.

The primary outcome was incident arrhythmia. Secondary outcomes included the incidence of arrhythmia subtype and CIED (ie, pacemaker and cardioverter defibrillator implantation).

Compared with controls, women with PCOS had a higher 25-year associated risk of arrhythmias (6.3 percent, 95 percent confidence interval [CI], 5.6–6.9 vs 4.2 percent, 95 percent CI, 3.9–4.5). The corresponding incidence rates were 23.8 and 15.7 per 10,000 person-years (adjusted hazard ratio [aHR], 1.48, 95 percent confidence interval [CI], 1.35–1.63).

Across subtypes of arrhythmias, PCOS was associated with an elevated risk of advanced atrioventricular block (aHR, 1.76, 95 percent CI, 1.05–2.93), cardiac arrest (aHR, 1.44, 95 percent CI, 1.03–2.08), and atrial fibrillation or flutter (aHR, 1.44, 95 percent CI, 1.20–1.73).

Additionally, women with PCOS had a higher likelihood of receiving a CIED compared with controls (incidence rates, 1.9 vs 1.1 per 10,000 person-years; aHR, 1.85, 95 percent CI, 1.30–2.63).

The associations were independent of use of metformin, oral contraception, spironolactone, antiandrogens, and glucagon-like peptide receptor analogues.

The findings underscore the importance of early cardiovascular risk assessment and preventive strategies for women with PCOS.