Heart Failure in Polycystic Ovarian Syndrome and Hypothyroidism: A Retrospective Large Database Analysis

Introduction  Polycystic ovarian syndrome (PCOS) carries similar risks to metabolic syndromes, and the population with hypothyroidism and concurrent PCOS may demonstrate exponential cardiovascular risk. There is a paucity of data on the cardiovascular outcomes of the population with PCOS. We aimed to address this gap. Methods  We queried the National Inpatient Sample Database (2016-2020), selected the population with a diagnosis of PCOS, and stratified them according to the presence or absence of hypothyroidism. Multivariable logistic regression models were applied to predict the outcomes. The primary outcome was mortality, while secondary outcomes were heart failure (HF), type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), stroke, hypertension (HTN), hyperlipidemia (HLD), and deep venous thrombosis (DVT).  Results  There were 78,470 hospitalizations with PCOS, and 14.6% (11,455) had hypothyroidism (36.3 years ± 10). Compared to the non-hypothyroid group, the population with hypothyroidism did not differ in terms of mortality (OR: 0.9; 95% CI: 0.6-1.4), HTN (OR: 1.04; 95% CI: 0.9-1.09), stroke (OR: 1.1; 95% CI: 0.8-1.4), or DVT (OR: 0.9; 95% CI: 0.7-1.3) (p > 0.05 for each). However, they had a higher likelihood of HF (OR: 1.2; 95% CI: 1.04-1.4), CKD (OR: 1.2; 95% CI: 1.02-1.3), T2DM (OR: 1.2; 95% CI: 1.1-1.3), and HLD (OR: 1.2; 95% CI: 1.2-1.3) (p < 0.05 for each). Conclusion  Among the population with PCOS, those with concurrent hypothyroidism had a higher association with HF, CKD, T2DM, and HLD. Risk stratification, prompt screening, close follow-up, and management may improve outcomes in this population.