A Systematic Review and Meta-Analysis of the Association Between Polycystic Ovary Syndrome and Coronary Artery Calcification — Research

Oluwaseun Osibogun, MD MPH, Oluseye Ogunmoroti, MD MPH, Olusola B Kolade, MD, Allison G Hays, MD, Victor Okunrintemi, MD, Anum S Minhas, MD, Martha Gulati, MD, Erin D Michos, MD MHS · Systematic review and meta-analysis

Polycystic ovary syndrome is usually managed as a reproductive and metabolic condition. This meta-analysis adds a cardiovascular dimension — and a concrete number.

Pooling seven studies, women with PCOS had roughly twice the odds of having detectable coronary artery calcium compared with women without it — a marker of early atherosclerosis showing up in a population often considered too young to worry about heart disease. The finding was consistent, with low statistical heterogeneity.

The practical takeaway is to treat PCOS as a cardiovascular risk flag, not just a fertility or metabolic one, and to consider earlier cardiovascular screening in these women. The resistance is guideline inertia — endocrinology and insurers slow to add cardiovascular screening for reproductive-age women.

We rate the evidence moderate-to-solid: a rigorous meta-analysis with low heterogeneity and consistent results, though built on observational studies and with one senior author disclosing industry ties. Its clinical significance is moderate — it identifies elevated risk in a large population of young women, but the optimal screening and intervention strategy isn’t yet defined.

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