Women with PCOS have heightened risk of cardiometabolic and cardiovascular diseases. Statement from Expert Group On Inositol in basic and clinical research and PCOS (EGOI-PCOS) and Italian Association of Hospital Cardiologist (ANMCO)

Giovanna Geraci¹Carmine Riccio²Fabrizio Oliva^3,4,5Domenico Gabrielli^4,6Furio Colivicchi⁷Massimo Grimaldi⁸Fabio Facchinetti⁹Vittorio Unfer^10,11*

• ¹UOC Cardiology - UTIC and Hemodynamics, S Antonio Abate, Erice (TP) Italy, Erice, Italy
• ²Department of Cardiovascular Diseases, Sant'Anna and San Sebastiano Hospital, Caserta, Campania, Italy
• ³ANMCO Research Center, Florence, Tuscany, Italy
• ⁴Foundation for Your Heart, Firenze, Italy
• ⁵Cardiology 1- Hemodynamics, Cardio-Thoraco-Vascular Department “A. De Gasperis”, ASST Grande Metropolitano Niguarda Hospital, Milan (MI), Italy, Milan, Italy
• ⁶U.O.C. Cardiology, Cardio-Thoraco-Vascular Department, A.O. San Camillo Forlanini, Rome (RM), Italy, Rome, Italy
• ⁷Clinical and Rehabilitation Cardiology Unit, Ospedale San Filippo Neri, Rome, Sicily, Italy
• ⁸U.O.C. Cardiology-UTIC, Miulli Hospital, Acquaviva delle Fonti (BA), Italy;, Acquaviva delle Fonti, Italy
• ⁹Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy;, Modena, Italy
• ¹⁰The Experts Group on Inositol in Basic and Clinical Research and on PCOS (EGOI-PCOS), Rome, Sicily, Italy
• ¹¹Saint Camillus International University of Health and Medical Sciences, Rome, Lazio, Italy

In recent years, Polycystic Ovary syndrome (PCOS) prevalence has gradually increased, and the investigation of the causal factors influencing etiopathogenesis is attracting attention. Several studies have highlighted that patients with PCOS exhibit an increased risk of cardiovascular disease (CVD) compared to healthy people, and these risks include occurrence of myocardial infarction, ischemic heart disease, and stroke. This correlation becomes particularly important when PCOS is diagnosed and consequently a specific treatment is recommended. Of note, women with PCOS may exhibit different pathological features even if quite often they are considered as a sole unique group of patients. Interestingly, the rate of CVD occurrence is differently linked to PCOS phenotypes. Data from literature demonstrate that CVD risks is strongly associated with those comorbidities frequently observed in PCOS, mainly metabolic alteration such as hypertension, abdominal obesity, dyslipidemia, insulin resistance, and atherosclerosis, that predispose individuals to CVD and type 2 diabetes. Women presenting PCOS, particularly those with hyperandrogenic pattern, seem more prone to develop CVD with respect to other PCOS patients. This may be related to genetic factors, dyslipidemia, and hypertension combined with excessive androgen, which may explain the increased risk factor of CVD in patients with PCOS. On these premises it becomes important to implement the therapeutical rationale, the risk assessment before treatment prescription, and to encourage meticulous patients' observation during medical examinations. This aspect becomes crucial particularly in adolescent patients, as in many cases PCOS may be predictive of CVD occurrence.