However, a direct association between polycystic ovaries and angiographic coronary artery disease has not been previously reported. Our finding of a high incidence of polycystic ovaries relates to the patients studied, all of whom had had coronary angiography. The women with polycystic ovaries had high testosterone and triglyceride levels, low HDL cholesterol levels, and some insulin resistance. Women with polycystic ovaries seen on ultrasonography often do not have the clinical features of the polycystic ovarian syndrome. The disorder probably exists on a continuum ranging from no symptoms to the fully developed syndrome.
Polycystic ovaries are the most common cause of anovulation with reduced production of estradiol.
Although estrone levels are elevated in women with polycystic ovaries, estrone is less potent than estradiol and may not be cardioprotective. Insulin resistance could be the link between polycystic ovaries and coronary artery disease. We found that C-peptide levels, a stable indicator of insulin production, were higher in women with polycystic ovaries than in women with normal ovaries. Abnormal lipid levels may also account for the increase in significant coronary artery disease. In addition, women with increased testosterone production may have a risk for adverse cardiac events similar to that of men.