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
Introduction
Erectile dysfunction (ED) is defined as the recurrent or persistent inability to achieve and/or maintain an erection in order for satisfactory intercourse to occur. The reported prevalence of ED in the general population ranges from 19% to 52% [1], [2]; this span is likely due to differences in the criteria used in defining ED and to the lack of systematic stratification by age. Despite this significant difference in ED prevalence, the age-related increase of ED and the correlation between ED and vascular risk factors—hypertension, hypercholsterolemia, cigarette smoking, diabetes and obesity—are common findings of several studies [1], [2], [3], [4], [5], [6]. These data suggest that ED may be considered a clinical manifestation of a functional (i.e. endothelial dysfunction) and/or a structural abnormality affecting penile circulation as a part of a more generalized vascular disorder [7], [8]. So far, little is known about the predictive role of ED as a marker of sub-clinical coronary artery disease (CAD). The aim of this prospective study was to evaluate patients presenting acute coronary syndromes (ACS) in our emergency units—and subsequently diagnosed with documented CAD—in terms of ED prevalence and its chronological and aetiological correlations with heart disease.
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Material and methods
In two emergency units, between February 2001 and July 2002, we prospectively evaluated 340 consecutive patients (mean age 62.5±8 years; range 33–86) with ACS who subsequently underwent coronary angiography. Both those patients presenting with a first angina episode and those with a known history of CAD underwent full cardiological assessments. For the purpose of this study, the only additional inclusion criterion was the detection (by coronary angiography) of a significant stenosis (>50%
Results
Twenty-seven out of 340 (12%) successive patients refused to enter the study and did not sign the informed consent. Thirteen out of the 313 remaining patients (4%) were excluded from the study due to unsatisfactory completion of the self-administered questionnaires. Three hundred patients completed the study protocol and were included in the data analysis. The clinical characteristics of the patient population are reported in Table 1.
Patient mean age was 62.5±8 years (range 33–86 years). The
Discussion
Evidence is accumulating in favor of considering ED as a vascular disorder [12], [13]. Common risk factors for atherosclerosis have been frequently found in patients with ED; in addition, the extent of ED has been related to the number and severity of vascular risk factors [13], [14]. Moreover, abnormal sexual function has been reported in patients with vascular diseases such as myocardial infarction, cerebrovascular accidents, hypertension and peripheral arterial disease [5]. Little is known,
Acknowledgments
The authors are grateful to Prof. Carey Berniz for reviewing the linguistic style of this manuscript. The study was supported by an unrestricted research grant by Pfizer Italia.
References (28)
- et al.
Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study
J. Urol.
(1994) - et al.
Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study
Prev. Med.
(2000) - et al.
Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function
Urology
(1999) - et al.
Coronary heart disease morbidity and mortality in hypercholesterolemic men predicted from an exercise test: the lipid research clinic coronary primary prevetion trial
J. Am. Coll. Cardiol.
(1989) - et al.
Prognostic value of exercise electrocardiograms in men at high risk of future coronary heart disease: multiplerisk factor intervention trial experience
J. Am. Coll. Cardiol.
(1986) - et al.
Relation of erectile dysfunction to angiographic artery disease
Am. J. Cardiol.
(2003) - et al.
Epidemiology of erectile dysfunction: results of the “Cologne Male Survey”
Int. J. Impot. Res.
(2000) - et al.
Frequency and determinants of erectile dysfunction in Italy
Eur. Urol.
(2000) - et al.
Erectile dysfunction in general medicine practice: prevalence and clinical correlates
Int. J. Impot. Res.
(2000) - et al.
Potential predictors of asymptomatic ischemic heart disease in patients with vasculogenic erectile dysfunction
Urology
(1997)
Erectile dysfunction and the cardiovascular patient: endotelial dysfunction is the common denominator
Heart
The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular function
Vasc. Med.
The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction
Urology
Assessment of depression: the depression inventory
Mod. Probl. Pharmacopsychiatry
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