Erectile Dysfunction Prevalence, Time of Onset and Association with Risk Factors in 300 Consecutive Patients with Acute Chest Pain and Angiographically Documented Coronary Artery Disease

Montorsi, Francesco; Briganti, Alberto; Salonia, Andrea; Rigatti, Patrìzio; Margonato, Alberto; Macchi, Andrea; Galli, Stefano; Ravagnani, Paolo; Montorsi, Piero

doi:10.1016/s0302-2838(03)00305-1

Cited by 515 publications

(426 citation statements)

References 26 publications

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“…The consensus panel defines cardiovascular risk as the risk of morbid events over a 3-to 5-year interval from the onset of ED (American College of Cardiology Foundation/American Heart Association [ACCF/AHA] class Ib) 3,4 and provides recommendations for the evaluation and management of cardiovascular risk in men with ED and no known CVD. The panel's approach broadens the use of the 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults to address an at-risk patient population that the guideline does not mention: men with ED.…”

Section: Evaluation and Management Of Cardiovascular Risk In The Patimentioning

confidence: 99%

“…16,17 Erectile dysfunction commonly occurs in the presence of silent CAD, 3,[18][19][20] with a time window between ED onset and a CAD event of 2 to 5 years (class Ia). 3,4,21 Furthermore, evidence suggests that ED is predictive of peripheral arterial disease (PAD) 22 and stroke. 23 In a population-based study of men 40 to 70 years of age, addition of ED status to the Framingham Risk Score (FRS) in a multivariate statistical model resulted in reclassification of 5 of 78 low-risk patients (Ͻ5% risk) to intermediate risk (5% to Ͻ10% risk).…”

Section: Sexual Inquiry Of All Menmentioning

confidence: 99%

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The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

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407

341

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The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. T he Princeton Consensus Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The first conference convened in June 1999 to develop recommendations for clinical management of sexual dysfunction in men and women with known cardiovascular disease (CVD). This conference also provided a multidisciplinary forum for evaluation of the potential cardiovascular risk posed by sexual activity in atrisk patients. The first Princeton Consensus Conference recommendations 1 included stratification of patients by level of cardiac risk associated with sexual activity based on existing CVD. Those at low risk could initiate or resume sexual activity and be treated for sexual dysfunction. For those at high risk, sexual activity was deferred until the cardiac condition was stabilized. The second Princeton Consensus Conference convened in June 2004 and expanded the recommendations of the first conference to emphasize risk factor evaluation and lifestyle management for all men with erectile dysfunction (ED). 2 The second conference recommendations also incorporated new information on the appropriate use of phosphodiesterase type 5 (PDE5) inhibitors in men with ED and concomitant CVD.The third Princeton Consensus Conference took place November 8 to 10, 2010, in Miami Beach, Florida. The group revisited and updated their 2005 recommendations regarding the cardiovascular risk associated with sexual activity in men with known CVD. 2 In addition, the third conference focused on the predictive value of vasculogenic ED in assigning cardiovascular risk in men of all ages, with the primary objective being development of an approach to cardiovascular risk assessment in younger men with ED and no known CVD. The role of testosterone in erectile function and cardiovascular health and the utility of testosterone replacement...

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Section: Evaluation and Management Of Cardiovascular Risk In The Patimentioning

confidence: 99%

Section: Sexual Inquiry Of All Menmentioning

confidence: 99%

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Nehra

Jackson

Miner

et al. 2012

Mayo Clinic Proceedings

Self Cite

407

341

View full text Add to dashboard Cite

show abstract

“…14 Although retrospective, cross-sectional and 'calculated' prospective designed studies indicate that ED may serve as a predictor of future cardiovascular events, well-described, large, prospective data on this association in a general population are scant. [16][17][18] The first large, prospective study reporting on incidence data of CHD in men with ED was within the framework of the PCPT (Prostate Cancer Prevention Trial). 12 In the placebo arm (n ¼ 9.457), ED was assessed by a structured interview and CHD was analysed according to the adverse events study protocol at study entry and every 3 months for the entire study period (7 years).…”

Section: Discussionmentioning

confidence: 99%

Is erectile dysfunction a predictor of cardiovascular events or stroke? A prospective study using a validated questionnaire

Ponholzer

Gutjahr

Temml³

et al. 2009

Int J Impot Res

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Erectile dysfunction (ED) is linked to various cardiovascular risk factors and may therefore serve as a predictor of cardiovascular events. To gain further insight into this relationship, we reviewed all data regarding hospital admission for cardial or cerebral vascular disease that occurred until 2008 in a cohort of men who underwent a health investigation in 2001. Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. In total, 2506 men with a negative history of cardial or cerebral vascular disease were analysed. During the 6.5-year followup, 58 cardiovascular events (2.3%) occurred. Men without ED (IIEF-5 422; n ¼ 1636) at baseline developed a cardiovascular event in 1.9% (n ¼ 32) as compared with 2.9% ( þ 52%; n ¼ 26) in those with ED (IIEF-5 p22; n ¼ 670). In contrast to age (hazard ratio (HR): 1.6; 1.2-1.8 for every decade), hypertension (HR: 1.88; 1.1-3.1) and diabetes (HR: 2.6; 1.2-5.8), ED was not an independent risk factor for a cardiovascular event. Although men with ED were at increased risk for future cardiovascular events, ED was not an age-independent predictor of cardiovascular events in our cohort.

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“…6,11 The Princeton II consensus guidelines therefore highlighted this role, invoking common risk factors and pathophysiology mediated through endothelial dysfunction. 103,104 Recommendations include that all men with ED should undergo a full medical assessment.…”

Section: Physiological Measurementsmentioning

confidence: 99%

“…The prevalence of ED was about eight times higher in patients with CAD. Montorsi et al 6 discovered an ED prevalence of 49% in men with symptomatic CAD, and patients stated that they noticed ED on average 39 months before the onset of angina. According to a pooled analysis, normal penile duplex results virtually excluded CAD; 7 conversely, a high proportion of men with ED 8 had silent CAD on coronary angiography and impaired coronary flow reserve.…”

Section: Introductionmentioning

confidence: 99%

Assessment of endothelial function in the patient with erectile dysfunction: an opportunity for the urologist

Tamler

Bar‐Chama

2008

Int J Impot Res

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Although there is now ample evidence that men with manifest coronary, cerebral and peripheral vascular disease and their risk factors are at highest risk for suffering from erectile dysfunction, recent findings demonstrate a strong connection between erectile dysfunction and endothelial dysfunction. This review explores how urologists and other providers may utilize the link between these conditions in clinical practice, compares methods of assessing endothelial dysfunction and finally speculates on how this additional information might impact treatment plans.

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Erectile Dysfunction Prevalence, Time of Onset and Association with Risk Factors in 300 Consecutive Patients with Acute Chest Pain and Angiographically Documented Coronary Artery Disease

Cited by 515 publications

References 26 publications

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

Is erectile dysfunction a predictor of cardiovascular events or stroke? A prospective study using a validated questionnaire

Assessment of endothelial function in the patient with erectile dysfunction: an opportunity for the urologist

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