Introduction Sexual fear is a known cause for avoidance of intercourse, especially in patients with chronic conditions. Aim Given the significant impact of fear of intercourse on the quality of life, we herein report our pilot results regarding the differences in the demographic, clinical, marital, and psychological characteristics of coronary artery disease (CAD) patients with and without sexual fear. Methods In this cross-sectional study conducted in Baqyiatallah Hospital, Tehran, Iran, in 2006, 87 married CAD patients were assessed for the presence of sexual fear. Subjects with and without sexual fear were compared for demographic and clinical data as well as for Hospital Anxiety and Depression Scale (HADS) and Revised-Dyadic Adjustment Scale (R-DAS) scores. Main Outcome Measure Demographic and clinical data, sexual fear (Relationship and Sexuality Scale), symptoms of anxiety and depression (HADS), and marital relation quality (R-DAS). Results Twenty-nine subjects were reported to have some degrees of fear of sexual intercourse and a lower frequency of sexual intercourse. Age, socioeconomic status, education level, tobacco smoking, and history of myocardial infarction were significantly different between those with and the ones without sexual fear. Body mass index, extent of coronary involvement, chronic obstructive pulmonary disease, hypertension, stroke, hyperlipidemia, history of diabetes, and the use of beta-blockers were not statistically different in the two groups. The subjects with sexual fear reported higher HADS depressive and R-DAS scores but not higher HADS anxiety scores. Conclusion Among different nonmodifiable and modifiable correlates of fear of sexual intercourse in CAD patients, marital relationship and depressive symptoms should be highlighted in future interventional studies with the aim of allaying such fears.

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It has been shown that cytomegalovirus (CMV) is present in coronary atherosclerotic plaques, but the clinical relevance of this presence remains to be elucidated. In this study we sought to examine CMV infection in atherosclerosis patients defined by different methods and to identify the clinical significance of CMV replication in the atherosclerotic plaques. The study included 105 consecutive patients who were admitted to our department and underwent coronary artery bypass grafting (CABG) surgical interventions. Coronary atherosclerotic specimens as well as 53 specimens from the mamillary artery of these same patients were analyzed. Enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) methods were used for evaluations. The CMV PCR test result was positive for 28 (26.7%) of patients with coronary artery atherosclerosis. After adjusting for other risk factors, coronary artery disease patients with a history of acute coronary syndrome were more likely to be positive for CMV PCR test (P = 0.027; odds ratio: 4.2; 95% CI: 1.18-15.0). They were also more likely to have a positive family history for cardiovascular diseases (CVD). This study confirms previous evidence about the replication of CMV virus in the atherosclerotic plaques of coronary arteries and brings clinical significance to this observation by showing a higher prevalence of acute coronary syndromes in those patients with CMV-infected plaques. Our study also suggests a familial vulnerability to CMV replication in the coronary artery walls.

Introduction Patients with coronary artery disease (CAD) may also suffer from mental and sexual problems, and we should consider the mutual influence such conditions have on each other. However, the interrelation between sexual and mental problems in the context of CAD has not been fully investigated, especially when it comes to gender. Aim Our aim was to evaluate sexuality and psychiatric symptoms among patients with CAD and the relation between them in each gender. Methods In this cross-sectional study, 550 (397 men and 153 women) patients with documented CAD were surveyed for anxiety and depression using the hospital anxiety and depression scale (HADS) self-administered questionnaire as well as the relation and sexuality scale (RSS). Three subscores were calculated for sexual function, frequency, and fear, with higher scores indicative of a poorer condition. Main Outcome Measures The HADS and the RSS. Results Depressive symptoms and anxiety were more severe among our female subjects than they were among the male ones. In addition, the scores for sexual frequency, sexual function, and the total RSS were significantly higher in women, while men had a significantly higher score for sexual fear. The total RSS score correlated with depressive symptoms in women (r = 0.19, P = 0.03), but not in the male subjects. Considering the subscores, a higher score for sexual frequency correlated with depressive symptoms in both genders; however, being afraid of sexual relation correlated with depressive symptoms only in men with CAD and their spouses (r = 0.18, P = 0.001). Conclusion We found that women with CAD have poorer sexual relation and more severe depressive symptoms than men do. Among men with CAD and their wives, fear of sexual relationship is a more serious problem. Such gender-specific characteristics and their interrelations ought to receive due consideration in the management of CAD.

Introduction Although the negative impact of coronary artery disease (CAD) on sexual and marital relation of the patients is known, data are lacking regarding possible gender difference. Aim We designed a study on patients with CAD to investigate sexual relation and marital adjustment and their association with regard to gender differences. Main Outcome Measures Questionnaires including the Dyadic Adjustment Scale for evaluating the couple's agreement on decisions and appropriate behavior, marital satisfaction, and marital cohesion, and the Relation and Sexuality Scale (RSS) for sexual function, frequency, and fear. Methods We surveyed 650 patients with documented CAD without any other major comorbidities. Results The patients were 464 men (73.1%) and 171 women (26.9%) with CAD. The mean age of the men and the women were 57.1 ± 11.6 years and 56.3 ± 9.7 years, respectively. The women had a significantly poorer dyadic adjustment and sexual relation than men, except for sexual fear, which was more prominent in men with CAD and their spouses. The sexual frequency and the total RSS scores correlated with all aspects of the patients' marital relation in both genders. However, only men suffered from a poorer dyadic satisfaction, dyadic consensus, affectional expression, and overall marital adjustment if they were more afraid of sexual relation. In women, but not men, sexual function was significantly associated with their dyadic satisfaction and their overall marital relation. Conclusions Poorer sexual relation and marital adjustment was detected in our women with CAD. To manage all the problems of the patients that may impact their cardiac status, we should consider factors such as fear of sexual activity in men sexual dysfunction in women, and their correlation with marital adjustment.