This study found a statistically significant increase in endostatin levels in PCOS. Endostatin inhibits angiogenesis (formation of new vessels) and lowers vascular endothelial growth factor (VEGF). Endothelin is also a cardiovascular biomarker. The cardiometabolic risk factors including endothelial dysfunction is seen in PCOS women. The rise in endothelin level thereby signifies vascular and myocardial damage in PCOS women. This evidence concerns the gene COL18A1 and polycystic ovary syndrome.