Objective: To evaluate coronary artery disease (CAD) prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. To describe the primary risk factors for CAD related to this association and their occasional differences according to AA topographies. Methods:This was an open, prospective, nonrandomized study that evaluated 95 patients (62 men and 33 women, mean age 63 ± 11.8). All patients, asymptomatic for CAD, had undergone aortic CT and coronary angiography. According to the AA topography, they were classified into three groups: 1) Patients with thoracic aortic aneurysm (TAA); 2) thoracoabdominal aortic aneurysm (TAAA); and 3) abdominal aortic aneurysm (AAA). A database was created to store information from clinical data and complementary examinations. Statistical analysis was performed using the Student's t test or analysis of variance (ANOVA) for continuous variables and chi-square test for categorical variables. P values < 0.05 were considered statistically significant.Results: CAD prevalence was 63.1%, and AAA was more prevalent than TAA and TAAA (76% vs. 70% vs. 30%, p = 0.001). The comparative analysis of CAD risk factors based on the aortic aneurysm topography revealed that smoking and dyslipidemia were more prevalent among AAA patients (74.5% vs. 42.3% vs. 60%, p = 0.01 and (54.2% vs. 19.9% vs. 60%, p = 0.007, vessel disease. Conclusion:Asymptomatic CAD is highly prevalent in AA patients, particularly among those with AAA. Study results suggest the need for diagnostic stratification for CAD in patients with AA, especially those with AAA.
OBJECTIVETo study the correlation between erectile dysfunction (ED) and myocardial perfusion impairment in men with suspected or diagnosed coronary artery disease (CAD). METHODSIn this prospective study a self-administered IIEF-5 questionnaire was answered by 287 patients that underwent myocardial perfusion imaging under both resting and stress condition with technetium-99m sestamibi, through gated SPECT nuclear scintigraphy technique, before and after physical or pharmacological stress. RESULTSSome degree of erectile dysfunction (group ED+) was found in 137 (47.8%) patients and in these, age was significantly higher (60.60±9.84 vs 50.67±9.94 -p<0.001)) than in those without erectile dysfunction (group ED-). In the ED+ group, it was observed a higher prevalence of hypertension, diabetes, myocardial infarction (MI) and percutaneous coronary angioplasty (PCTA). Regardless of the age factor, ED+ patients also presented higher occurrence of myocardial perfusion impairment (necrosis and/or ischemia) and left ventricular systolic wall motion and thickening abnormalities. CONCLUSIONPatients with ED have higher estimated probability of presenting segmental myocardial perfusion and functional contraction impairment and, therefore, CAD, independent of the aging factor. The authors conclude that ED may be considered not only a marker for CAD but also a condition related to the occurrence of major coronary events such as MI and PCTA.KEY WORDS erectile dysfunction, coronary artery disease, nuclear medicine, myocardial perfusion, risk factors, atherosclerosis
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