Is there a relationship between severity of coronary artery disease and severity of erectile dysfunction?

Abstract

Introductıon:The correlation between erectile dysfunction (ED) and coronary artery disease has been emphasized and ED has been recognized as a potential independent risk factor and/or predictor of coronary artery disease (CAD). We evaluated the association between the number of occluded coronary arteries in myocardial infarction (MI) patients with the severity of ED, and investigated the influence of related risk factors in our study group. Materials and Methods: 183 male patients who underwent coronary angiography because of acute MI from November 2009 to May 2011 were included. Following the stabilization of patients after the treatment, each patient was evaluated for erectile functionality. Risk factors such as age, diabetes, smoking, waist circumference, hypertension, and hematologic parameters were recorded. Results: Among 183 patients with a mean age of 55.2 years who underwent coronary angiography due to acute MI, 100 (54.64%) had ED, while the ED rate was 45.36% (44/97) in cases of single-vessel disease, 64.5% (31/48) in cases of two-vessel disease, and 65.7% (25/38) in cases of three-vessel disease. The mean IIEF score was 24.2 ± 4.3, 20.4 ± 4.9 and 20.5 ± 4.2 for single or two or three-vessel disease, respectively. The presence of hypertension aggravated ED only in patients with three-vessel disease and increased total and LDL cholesterol levels in patients with single-vessel or two-vessel disease were accompanied by significantly decreasing IIEF scores. Conclusıon: The severity of ED correlated with the number of occluded vessels documented by coronary angiography, in male patients with acute myocardial infarction. In addition, the presence of hypertension had a significant influence over erectile function only in patients with three-vessel occlusion.

Erectile Dysfunction Severity and SYNTAX Score in Coronary Artery Disease

“…Accordingly, they concluded that CAC score increased as the severity of ED increased. On the other hand, Canat et al [28] investigated the relationship between ED and CAD in terms of number of occluded vessels and evaluated 183 patients who underwent angiography after acute myocardial infarction. They reported no difference between the patient groups with one vessel occluded, two vessels occluded, and three vessels occluded in terms of risk factors (age, waist circumference, lipid profile, diabetes, and smoking) excluding hypertension.…”

“…Angiograms of the patients were scored and divided into three groups according to the SS as low (SS ≤22), intermediate (SS between [23][24][25][26][27][28][29][30][31][32], and high (SS ≥33) [8]. After coronary angiography, erectile performance statuses of all patients were evaluated using the International Index of Erectile Function (IIEF), which is a validated 15-item self-administered questionnaire [10].…”

Clinical significance and expression of microRNA in diabetic patients with erectile dysfunction

“…The pathogenesis of diabetic ED is complex. Diabetic angiopathies include macrovascular disease, microvascular disease and endothelial dysfunction, which are all known to be involved in the pathophysiological process of ED (5)(6)(7).…”

Erectile Dysfunction and Coronary Artery Disease: Two manifestations, one same underlying mechanism

“…Therefore, it is believed that ED and coronary artery disease (CAD) are clinical manifestations of the same pathophysiological process, product of a severe endothelial dysfunction [10][11][12]. In the study conducted by Demirkol S et al, it was found that erectile function was signi icantly decreased in patients who presented both microvascular angina (syndrome X) and CAD, thus they conclude that ED and syndrome X are manifestations of a common vascular phenomenon that includes endothelial dysfunction as the mechanism underlying both conditions [4].The pathophysiology of microvascular angina has not been clearly elucidated, although several abnormalities have been proposed including: alteration in coronary low reserve, insulin resistance, abnormal autonomic control and microvascular spasm; all these, also associated with endothelial dysfunction, which is another traditional risk factor for cardiovascular disease and occurs before the development of apparent functional or structural systemic vascular disease [6,12]. It is characterized by a decrease in the bioavailability of endogenous nitric oxide (NO) and increase in plasma levels of endothelin-1, promoting in turn an increase in oxidative stress and vasoconstrictor mediators such as angiotensin II, causing generalized damage in the vascular endothelium, being the arteries of the penis more susceptible due to their size and therefore affected earlier 4 .…”

“…Therefore, it is believed that ED and coronary artery disease (CAD) are clinical manifestations of the same pathophysiological process, product of a severe endothelial dysfunction [10][11][12]. In the study conducted by Demirkol S et al, it was found that erectile function was signi icantly decreased in patients who presented both microvascular angina (syndrome X) and CAD, thus they conclude that ED and syndrome X are manifestations of a common vascular phenomenon that includes endothelial dysfunction as the mechanism underlying both conditions [4].…”