Relationship between erectile dysfunction and coronary anatomy in patients with ischemic heart disease debut

Eur Urol Suppl 2013;12;e208 Garcia-Cruz E.1, Bonet A.2, Asiain I.1, Luque P.1, Freixa R.2, Alcaraz A.1

INTRODUCTION & OBJECTIVES: The prevalence of erectile dysfunction (ED) in patients with high cardiovascular risk (CVR) is elevated. ED precedes the first ischemic event in 70% of cases, with an average time of two years between onset of ED and the first ischemic event. The new clinical guidelines on prevention of CVR consider ED a marker for cardiovascular disease and an indication to commence a CVR study. The objective of this work is to evaluate the relationship between the ED and the coronary anatomy in a group of patients undergoing coronary angiography for an ischemic heart disease debut.

MATERIAL & METHODS: 99 men undergoing coronary angiography in context of a debut of ischemic heart disease in its various manifestations (STEMI, NSTEMI or stable angina) were analyzed from October 2011 to October 2012. Erectile function was recorded using the EHS questionnaire. We recorded clinical, physical, laboratory, and echocardiographic data, as well as the coronary indication. Significant Coronary artery Disease (SCD) was considered in the case of stenosis greater than 50%. EHS = 4 was considered as normal erectile function and EHS <4 as DE.

RESULTS: Prevalence of ED 62%. Mean age 62 years. The population of men with and without ED were comparable, except for Hypertension (72.1% HTA in ED vs 50%  in no-ED, P = 0.026), Intermittent Claudication (23% IC in ED vs 5% in no-ED, p = 0.02), Stroke / TIA (11.5% Stroke/TIA in ED vs 0% in no-ED, p = 0.03).

 87% of patients with ED showed SCD vs 82% of the no-ED patients (p = 0, 552). No statistical differences were found when analyzing separately each of the coronary arteries or in the number of affected vessels in relation to ED (52.5% of multivessel disease in ED vs 34.2% in no-ED, p = 0.076).

CONCLUSIONS: The presence of ED is not significantly related to the presence or severity of SCD in a population of men with coronary indication in the context of ischemic heart disease debut.