We sought to investigate whether erectile dysfunction (ED) is a predictor of future cardiovascular events and death in diabetic patients with silent coronary artery disease (CAD) and whether there are predictors of cardio- vascular events and death among CAD diabetic patients with ED. Case-control studies showed that ED is associated with CAD in diabetic patients, but no prospective study is available. Type 2 diabetic men (n 291) with silent CAD angiographically documented were recruited. Erectile dysfunction was assessed by the International Index Erectile Function-5 questionnaire. During a follow-up period of 47.2 21.8 months (range 4 to 82 months), 49 patients experienced major ad- verse cardiac events (MACE). The difference in ED prevalence between patients with and those without MACE was significant (61.2% vs. 36.4%; p 0.001). Cox regression analysis showed that ED predicted MACE (hazard ratio [HR] 2.1; 95% confidence interval [CI] 1.6 to 2.6; p 0.001). Among patients with CAD and ED, the Kaplan-Meier method showed that the statin (Mantel log-rank test: 3.921; p 0.048) and 5-phosphodiesterase (5-PDE) inhibitor use (Mantel log-rank test: 4.608; p 0.032) were associated with a lower rate of MACE. Cox regression analysis showed that statin use (HR 0.66; 95% CI 0.46 to 0.97; p 0.036) reduced MACE. Treat- ment with 5-PDE inhibitors did not enter the model, but its p value was very near to the significant level (HR 0.68; 95% CI 0.46 to 1.01; p 0.056). Our data first show that ED is a powerful predictor of cardiovascular morbidity and mortality in diabetic patients with silent CAD and that the treatment with statins and 5-PDE inhibitors might reduce the occurrence of MACE among CAD diabetic patients with ED. (J Am Coll Cardiol 2008;51:2040–4) © 2008 by the American College of Cardiology Foundation
ERECTILE DYSFUNCTION AS PREDICTOR OF CARDIOVASCULAR EVENTS AND DEATH IN DIABETIC PATIENTS WITH ANGIOGRAPHICALLY PROVEN ASYMPTOMATIC CORONARY ARTERY DISEASE: A POTENTIAL PROTECTIVE ROLE FOR STATINS AND 5-PHOSPHODIESTERASE INHIBITORS
PUJIA A;
2008-01-01
Abstract
We sought to investigate whether erectile dysfunction (ED) is a predictor of future cardiovascular events and death in diabetic patients with silent coronary artery disease (CAD) and whether there are predictors of cardio- vascular events and death among CAD diabetic patients with ED. Case-control studies showed that ED is associated with CAD in diabetic patients, but no prospective study is available. Type 2 diabetic men (n 291) with silent CAD angiographically documented were recruited. Erectile dysfunction was assessed by the International Index Erectile Function-5 questionnaire. During a follow-up period of 47.2 21.8 months (range 4 to 82 months), 49 patients experienced major ad- verse cardiac events (MACE). The difference in ED prevalence between patients with and those without MACE was significant (61.2% vs. 36.4%; p 0.001). Cox regression analysis showed that ED predicted MACE (hazard ratio [HR] 2.1; 95% confidence interval [CI] 1.6 to 2.6; p 0.001). Among patients with CAD and ED, the Kaplan-Meier method showed that the statin (Mantel log-rank test: 3.921; p 0.048) and 5-phosphodiesterase (5-PDE) inhibitor use (Mantel log-rank test: 4.608; p 0.032) were associated with a lower rate of MACE. Cox regression analysis showed that statin use (HR 0.66; 95% CI 0.46 to 0.97; p 0.036) reduced MACE. Treat- ment with 5-PDE inhibitors did not enter the model, but its p value was very near to the significant level (HR 0.68; 95% CI 0.46 to 1.01; p 0.056). Our data first show that ED is a powerful predictor of cardiovascular morbidity and mortality in diabetic patients with silent CAD and that the treatment with statins and 5-PDE inhibitors might reduce the occurrence of MACE among CAD diabetic patients with ED. (J Am Coll Cardiol 2008;51:2040–4) © 2008 by the American College of Cardiology FoundationI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
