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Cardiovascular outcomes of bilateral oophorectomy: A systematic review and meta-analysis
Tanawat Attachaipanich1, Suthinee Attachaipanich2, Kotchakorn Kaewboot3
1Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, 64110, MO, USA.
Insights
Bilateral oophorectomy increases cardiovascular disease (CVD) risk, especially when performed before menopause. This surgical procedure is linked to higher risks of heart failure and coronary artery disease in younger women.
Area of Science:
- Cardiovascular Science
- Reproductive Endocrinology
- Surgical Outcomes Research
Background:
- Cardiovascular disease (CVD) risk escalates post-menopause in women.
- The impact of bilateral oophorectomy on cardiovascular (CV) outcomes requires clarification.
- This study investigates the association between bilateral oophorectomy and CV outcomes.
Purpose of the Study:
- To evaluate the cardiovascular outcomes in women who have undergone bilateral oophorectomy.
- To determine if bilateral oophorectomy influences the risk of cardiovascular events.
- To assess the impact of age at surgery on these cardiovascular risks.
Main Methods:
- A systematic literature search was performed across PubMed, Embase, Web of Science, and Cochrane CENTRAL.
- Included studies compared CV outcomes in women with and without bilateral oophorectomy.
- Meta-analysis utilized a random-effects model on data from 18 studies (2,414,600 participants).
Main Results:
- Bilateral oophorectomy showed a marginally increased risk of CVD (HR 1.05) and a higher risk of heart failure (HR 2.25).
- Premenopausal bilateral oophorectomy was linked to increased CVD (HR 1.15) and coronary artery disease (HR 1.26) risks.
- Postmenopausal bilateral oophorectomy did not demonstrate an increased risk of cardiovascular events.
Conclusions:
- Bilateral oophorectomy is associated with elevated cardiovascular event risk, particularly when performed premenopausally.
- The findings highlight the importance of age at surgery in assessing CV risk after oophorectomy.
- Further research is needed for prevention strategies and risk stratification in affected women.
Background:
Cardiovascular disease (CVD) risk significantly increases in women after menopause. However, the cardiovascular (CV) outcomes in women who undergo bilateral oophorectomy remain unclear. This study aimed to evaluate the CV outcomes associated with bilateral oophorectomy.
Methods:
A systematic search was conducted across 4 databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to March 25, 2025, without language restrictions. Studies comparing CV outcomes in women who underwent bilateral oophorectomy versus those who did not were included. A random-effects model was used for meta-analysis.
Results:
A total of 18 studies, comprising a total of 2,414,600 participants, were included. Bilateral oophorectomy was associated with a marginally increased risk of CVD compared to control (pooled HR 1.05, 95 %CI 1.00-1.11, p = 0.05). Bilateral oophorectomy was also associated with a higher risk of heart failure (pooled HR 2.25, 95 %CI 1.15-4.41, p = 0.02). When stratified by age at surgery, bilateral oophorectomy performed at a premenopausal age was associated with a higher risk of CVD (pooled HR 1.15, 95 %CI 1.02-1.30, p = 0.03) and coronary artery disease (pooled HR 1.26, 95 %CI 1.15-1.39, p < 0.01). In contrast, bilateral oophorectomy performed at postmenopausal age was not associated with an increased risk of CV events.
Conclusions:
Bilateral oophorectomy is associated with an increased risk of CV events, particularly when performed at a premenopausal age. Further research is warranted to determine appropriate prevention strategies and risk stratification in this population.
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