Subclinical coronary artery atherosclerosis in patients with erectile dysfunction.

J Am Coll Cardiol. 2005 Oct 18;46(8):1503-6. Epub 2005 Sep 28.
Chiurlia E, D’Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG.

Institute of Cardiology, University of Modena and Reggio Emilia, Modena, Italy. emiliochiurlia@virgilio.it

OBJECTIVES: The purpose of our study was to assess the prevalence and extent of coronary artery atherosclerosis in asymptomatic patients with vascular erectile dysfunction (ED). BACKGROUND: An association between ED and ischemic heart disease has been suggested, but it is unknown if it represents a marker of subclinical coronary atherosclerosis. METHODS: We studied 70 consecutive patients with vascular ED, evaluated by penile Doppler, and 73 control subjects with no history of coronary artery disease. We measured traditional coronary risk factors, circulating levels of C-reactive protein (CRP), endothelial function by ultrasound of brachial artery, and coronary artery calcification by multi-slice computed tomography. RESULTS: The patients and the control group were similar for age, race, and coronary risk score. Patients with ED had significantly higher high-sensitivity C-reactive protein levels (2.62 vs. 1.03 mg/l, p < 0.001). Flow-mediated dilation of the brachial artery was more impaired in patients with ED than in controls (2.36 vs. 3.92, p < 0.001). Coronary artery calcification was more frequent in individuals with ED than in control subjects (p = 0.01). Multiple logistic regression analysis showed that patients with ED had an overall odds ratio of 3.68 for having calcium score above the 75th percentile, compared to the controls. CONCLUSIONS: Coronary atherosclerosis is more severe in patients with vascular ED; ED predicts the presence and extent of subclinical atherosclerosis independent of traditional risk factors for cardiovascular disease. Thus, ED may be considered an additional, early warning sign of coronary atherosclerosis.16226175 [PubMed - indexed for MEDLINE]

• Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease.
• Endothelial function in patients with vasculogenic erectile dysfunction.
• Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction.
• Association between erectile dysfunction and coronary artery disease: Matching the right target with the right test in the right patient.
• Erectile dysfunction in healthy subjects predicts reduced coronary flow velocity reserve.