No signs of subclinical atherosclerosis after risk-reducing salpingo-oophorectomy in BRCA1/2 mutation carriers

•BRCA1/2 mutation carriers have a relatively healthy cardiovascular risk profile.•No association between premature menopause and subclinical atherosclerosis.•Premature surgical menopause does not increase carotid intima-media thickness.•Pulse wave velocity is not related to time since preventive sal...

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Published in:	Journal of cardiology Vol. 77; no. 6; pp. 570 - 575
Main Authors:	van Bommel, Majke H.D., de Jong, Marieke Arts, Steenbeek, Miranda P., Bots, Michiel L., van Westerop, Liselore L.M., Hopman, Maria T.E., Hoogerbrugge, Nicoline, de Hullu, Joanne A., Maas, Angela H.E.M.
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-06-2021
Subjects:	Adult Atherosclerosis - genetics Atherosclerosis - prevention & control BRCA1 Protein - genetics BRCA1/2 mutation BRCA2 Protein - genetics Carotid Intima-Media Thickness Cross-Sectional Studies Female Humans Intima-media thickness Middle Aged Mutation Pulse Wave Analysis Pulse wave velocity Risk-reducing salpingo-oophorectomy Salpingo-oophorectomy Subclinical atherosclerosis Intima-media thickness Pulse wave velocity Risk-reducing salpingo-oophorectomy Subclinical atherosclerosis BRCA1/2 mutation
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Summary:	•BRCA1/2 mutation carriers have a relatively healthy cardiovascular risk profile.•No association between premature menopause and subclinical atherosclerosis.•Premature surgical menopause does not increase carotid intima-media thickness.•Pulse wave velocity is not related to time since preventive salpingo-oophorectomy. BRCA1/2 mutation carriers are generally exposed to early menopause due to risk-reducing salpingo-oophorectomy (RRSO) around the age of 40 years. This risk-reducing intervention is based on a 10–40% life-time risk of ovarian cancer in this population. Although effective, premature and acute menopause induces non-cancer related morbidity in both the short and long term. Little is known about the impact of RRSO on the cardiovascular system. This cross-sectional study explored the relationship between time since RRSO and signs of subclinical atherosclerosis, as measured by carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), in 165 BRCA1/2 mutation carriers. All participants, aged 40 to 63 years, underwent RRSO before the age of 45 years, and at least 5 years ago. Cardiovascular risk factors were assessed by questionnaires and a single screening visit. Data were analyzed using linear regression models. Mean CIMT was 692.7 μm (SD 87.0), and mean central PWV 6.40 m/s (SD 1.42). After adjustment for age and several relevant cardiovascular risk factors, time since RRSO was not associated with CIMT (β=0.68 μm; 95% CI –4.02, 5.38) and PWV (β=44 mm/s; 95% CI –32, 120). Compared to women of a reference group from the general population, lower systolic blood pressure [mean difference 12 mmHg; 95% confidence interval (CI) 10, 14] was found in BRCA1/2 mutation carriers. We found that, in BRCA1/2 mutation carriers, at 5 to 24 years follow-up, time since RRSO is not related to development of subclinical atherosclerosis. However, the follow-up period in these relatively young women might have been too short.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0914-5087 1876-4738
DOI:	10.1016/j.jjcc.2020.11.005