Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology Pub Date : 2024-12-01 DOI:10.1016/j.jaccao.2024.09.011

Maarten J. Beekman MD , Lara Terra MD , Bernadette A.M. Heemskerk-Gerritsen PhD , Carlijn M. van der Aalst PhD , Jeanine E. Roeters van Lennep MD, PhD , Marc van Beurden MD, PhD , Helena C. van Doorn MD, PhD , Joanne A. de Hullu MD, PhD , Eleonora B.L. van Dorst MD , Constantijne H. Mom MD, PhD , Marian J.E. Mourits MD, PhD , Brigitte F.M. Slangen MD, PhD , Annemarieke Bartels-Rutten MD, PhD , Ricardo P.J. Budde MD, PhD , Miranda M. Snoeren MD , Tim Leiner MD, PhD , Pim A. de Jong MD, PhD , Rozemarijn Vliegenthart MD, PhD , R. Nils Planken MD, PhD , Casper Mihl MD, PhD , Flora E. van Leeuwen PhD

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引用次数: 0

Abstract

Background

Premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at high familial risk of ovarian cancer leads to immediate menopause. Although early natural menopause is associated with increased cardiovascular disease risk, evidence on long-term cardiovascular disease risk after early surgical menopause is scarce.

Objectives

We sought to determine the long-term influence of the timing of RRSO on the development of coronary artery calcium (CAC), an established marker for cardiovascular disease risk.

Methods

We conducted a cross-sectional study (N = 733) nested in a nationwide cohort of women at high familial risk of ovarian cancer. In women aged 60-70 years (n = 328), we compared CAC scores between women with a premenopausal RRSO (age ≤45 years) and women with a postmenopausal RRSO (age ≥54 years), using multivariable Poisson analyses. Within the premenopausal RRSO group (n = 498), we also examined the effect of age at RRSO. In addition, we compared the premenopausal RRSO group with an external reference cohort (n = 5,226).

Results

Multivariable analyses showed that the prevalence rates of any CAC (CAC >0), at least moderate CAC (CAC >100), and severe CAC (CAC >400) were comparable between the premenopausal and postmenopausal RRSO groups (relative risk [RR]: 0.93; 95% CI: 0.75-1.15 for any CAC; RR: 0.71; 95% CI: 0.43-1.17 for at least moderate CAC; RR: 0.81; 95% CI: 0.30-2.13 for severe CAC). There was no difference in CAC between the premenopausal RRSO group and a similar aged reference cohort. Timing of premenopausal RRSO (early premenopausal RRSO [<41 years] vs late premenopausal RRSO [41-45 years]) did not affect the outcomes.

Conclusions

Our results do not show a long-term adverse effect of surgical menopause on the development of CAC.

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预防性绝经前双侧输卵管卵巢切除术后冠状动脉钙评分。

背景：绝经前风险降低输卵管卵巢切除术（RRSO）的妇女在卵巢癌的高家族风险导致立即绝经。虽然早期自然绝经与心血管疾病风险增加有关，但早期手术绝经后长期心血管疾病风险的证据很少。目的：我们试图确定RRSO时间对冠状动脉钙（CAC）发展的长期影响，CAC是心血管疾病风险的既定标志。方法：我们进行了一项横断面研究（N = 733），嵌套在全国范围内具有卵巢癌高家族风险的妇女队列中。在60-70岁的女性中（n = 328），我们使用多变量泊松分析比较了绝经前RRSO（年龄≤45岁）和绝经后RRSO（年龄≥54岁）女性的CAC评分。在绝经前的RRSO组（n = 498）中，我们还研究了年龄对RRSO的影响。此外，我们将绝经前RRSO组与外部参考队列（n = 5226）进行了比较。结果：多变量分析显示，在绝经前和绝经后RRSO组中，任何CAC （CAC >00）、至少中度CAC （CAC >00）和重度CAC （CAC bbb400）的患病率具有可比性(相对危险度[RR]: 0.93；任何CAC的95% CI: 0.75-1.15；RR: 0.71;至少中度CAC的95% CI: 0.43-1.17；RR: 0.81;重度CAC 95% CI: 0.30-2.13)。绝经前RRSO组与相似年龄参考队列之间CAC无差异。绝经前RRSO（早期绝经前RRSO）的时间[结论：我们的研究结果没有显示手术绝经对CAC的发展有长期的不良影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jacc: Cardiooncology Multiple-

CiteScore

12.50

自引率

6.30%

发文量

106

期刊介绍： JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge. The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention. Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.