SAT-137 PCOS: From Ovaries to Arteries - An Evolving Recognition of Vascular Risk for Women

Abstract Disclosure: R. Trivedi: None. S. Chrysafides: None. N. Rahman: None. A. Lim: None. A.F. Firek: None. I. Munir: None. A. Yang: None. M. Firek: None. Background: PCOS is the most common endocrine disorder present in women of reproductive age and is characterized by various degrees of insulin resistance placing them at risk for dyslipidemia, hypertension, diabetes, and nonalcoholic steatohepatitis. Importantly, these metabolic determinants may increase the risk for future atherosclerotic and venous thrombotic events such as myocardial infarction, stroke, and heart failure. Traditionally therapy for PCOS has largely been targeted at cosmetic therapies and lifestyle modifications, the purpose of this study is to explore metabolic and vascular risks of PCOS for adverse health outcomes and overall risk for general hospitalizations. Method: This study compared vascular health consequences of women with PCOS to women without PCOS utilizing deidentified National Inpatient Sample (NIS) data for hospital admissions from 2016-2022. We analyzed a total of 205,960 women hospitalized aged 18-80 with a concomitant diagnosis of PCOS. Data was separated by age categories (18 to 30, 30 to 40, 40 to 50, and 50 to 80) and by reason for hospitalization (thrombotic, atherosclerotic and cerebrovascular disease). These populations were compared to women without PCOS who were hospitalized for the same reasons in the same time span. Within these groups, we compared the incidence of new ischemic events including myocardial infarction (MI), stroke, peripheral vascular disease (PVD), and death during hospitalization. Results: When compared to women without PCOS, a significantly greater percentage of women with PCOS who were hospitalized for thrombotic, atherosclerotic, and cerebrovascular disease were below the age of 50 (92.59% vs 27.03% for thrombotic, 74.21% vs 11.49% for atherosclerotic, and 86.06% vs 12.18% for cerebrovascular diseases, p<0.05). When analyzing MI, PVD, and stroke in thrombotic populations, women with PCOS had an increase in incidence of stroke (14.81% vs 11.97%). Additionally, women with PCOS in the atherosclerotic population had a comparable overall incidence of MI when compared to without PCOS group (91.82% vs 94.13%). Although the incidence of MI and PVD were lower in both thrombotic and atherosclerotic groups with PCOS, death rates during hospitalization were comparable (2.90% vs 2.47% and 3.54% vs 3.14% respectively). Conclusion: Women with PCOS are at increased relative risk for acute overall hospitalizations and vascular events compared to women without PCOS. Despite being at a significantly younger age on average, women with PCOS face equivalent mortality from these vascular events compared to women without PCOS. Our findings support expanding guidelines to recognize PCOS as a condition with increased vascular risk and to consider early and aggressive interventions for risk reduction. Presentation: Saturday, July 12, 2025