TY - JOUR
T1 - Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy
AU - Beekman, Maarten J.
AU - Terra, Lara
AU - Heemskerk-Gerritsen, Bernadette A.M.
AU - van der Aalst, Carlijn M.
AU - Roeters van Lennep, Jeanine E.
AU - van Beurden, Marc
AU - van Doorn, Helena C.
AU - de Hullu, Joanne A.
AU - van Dorst, Eleonora B.L.
AU - Mom, Constantijne H.
AU - Mourits, Marian J.E.
AU - Slangen, Brigitte F.M.
AU - Bartels-Rutten, Annemarieke
AU - Budde, Ricardo P.J.
AU - Snoeren, Miranda M.
AU - Leiner, Tim
AU - de Jong, Pim A.
AU - Vliegenthart, Rozemarijn
AU - Planken, R. Nils
AU - Mihl, Casper
AU - Vonder, Marleen
AU - Oudkerk, Matthijs
AU - Gaarenstroom, Katja N.
AU - Gratama, Jan Willem C.
AU - van Engelen, Klaartje
AU - van der Kolk, Lizet E.
AU - Collée, J. Margriet
AU - Wevers, Marijke R.
AU - Ausems, Margreet G.E.M.
AU - Berger, Lieke P.V.
AU - Gomez Garcia, Encarna B.
AU - van Asperen, Christi J.
AU - Hooning, Maartje J.
AU - de Koning, Harry J.
AU - Maas, Angela H.E.M.
AU - van Leeuwen, Flora E.
N1 - Funding Information:
The authors thank all the women who participated in this study and would also like to thank the Hereditary Breast and Ovarian cancer study Netherlands (HEBON) consortium for approving this study. The authors also thank Sandra Fase for her extensive administrative assistance. Lastly, the authors thank the employees at all participating hospitals for their help in facilitating the study visits.
Publisher Copyright:
© 2024 The Authors
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - BRCA
KW - CAC
KW - cardiovascular disease
KW - ovarian cancer
KW - RRSO
KW - surgical menopause
U2 - 10.1016/j.jaccao.2024.09.011
DO - 10.1016/j.jaccao.2024.09.011
M3 - Article
SN - 2666-0873
VL - 6
SP - 922
EP - 931
JO - JACC: CardioOncology
JF - JACC: CardioOncology
IS - 6
ER -