Independent Determinants of Coronary Artery Disease in Erectile Dysfunction Patients

Abstract

Introduction There is growing evidence of a link between erectile dysfunction (ED) and coronary artery disease (CAD). Aims The purpose of this study was to explore the independent determinants of CAD in ED outpatients. Methods This study enrolled 243 patients, ranging in age from 21 to 81 years old, suffering from ED as diagnosed by the International Index of Erectile Function (IIEF) scores. All patients underwent exercise stress tests or thallium-201 single-photon emission computed tomography perfusion imagings. Based on examination results, patients were divided into study (22 patients with a positive finding) and control groups (221 patients with a negative finding). Main Outcome Measures The differences of demographic characteristics, biochemical profiles, pro-inflammatory and inflammatory markers, and echocardiographic characteristics between study and control group were compared. Results The age, presence of DM and current smoking status were significant high in the study group. A significant lower high-density lipoprotein (HDL) cholesterol level, a higher percentage of HDL cholesterol level<40 mg/dL, and a higher apo-lipoprotein B/A1, high sensitive C-reactive protein (hs-CRP) and homocysteine found in the study group. The Framingham cardiac risk scores, the ratio of mitral inflow velocity to early diastolic velocity in the annulus derived by tissue Doppler imaging (E/Et), the ratio of E/Et ≥ 15, the value of carotid intima-media thickness (IMT), and IMT ≥ 1 mm were higher in study group than in the control group. In stepwise multiple logistic regression analysis, a high waist-to-hip ratio (WHR), high IMT, high E/Et, hs-CRP levels, LDL cholesterol ≥ 130 mg/dL, smoking status, and the presence of DM and metabolic syndrome (MS) were independent determinants of CAD in ED patients. Conclusions This study first shows the independent determinants of CAD in ED outpatients. This novel finding may improve the screening of low-risk ED patients for CAD.

Evaluation of Endothelial Function with Brachial Artery Ultrasound in Men with or Without Erectile Dysfunction and Classified as Intermediate Risk According to the Framingham Score

“…Actually, the pathophysiology of the endothelial function and the relationship between cardiovascular events and ED are not fully understood so far. Previous studies showed that ED is predictive of subsequent atherosclerotic cardiovascular events [31][32][33][34]. This study suggests that ED may be a marker for endothelial dysfunction, even in patients without clinical evidence of atherosclerosis.…”

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions

“…Our previous study results also showed independent determinants, including many traditional cardiovascular risk factors and markers of vascular wall and ventricular function, of CAD in ED outpatients. 6 In addition, metabolic syndrome (MS), which refers to the clustering of criteria such as DM or impaired glucose tolerance, hypertension, obesity, dyslipidemia and/or microabluminuria, is closely associated with cardiovascular morbidity and mortality. 7,8 The relationship of ED and MS had been well established by several studies.…”

Weaker Masturbatory Erection May Be a Sign of Early Cardiovascular Risk Associated with Erectile Dysfunction in Young Men Without Sexual Intercourse

“…IR was defined as QUICKI <0.357 derived from Hrebicek's population‐based study [20]. High level of glycosylated serum protein (GSP) [16] and hs‐CRP [21,22], which had been considered to be associated with CVD, were screened as risk factors for ED. The diagnostic criteria of these biochemical indicators, derived from National Clinical Testing Criterion, were defined as GSP >236 mg/L and hs‐CRP >3.00 mg/L, respectively.…”