Association between erectile dysfunction and coronary artery disease and its severity

Abstract

Background/aims: To investigate the prevalence of erectile dysfunction (ED) in patients with coronary artery disease (CAD), its relationship between the severity of ED and the extent of coronary vessel involvement and to register the mean time interval between them.

Methods: 240 patients with CAD divided into three age-matched groups: Group 1 (n = 60), ACS with one-vessel disease (1VD); group 2 (n = 60), ACS with 2,3VD; group 3 (n = 60), CSA. Control group (C, n = 60) was composed of patients with suspected CAD who were found to have entirely normal coronary arteries by angiography. ED as any value <26 according to the Gensini's scores and according to the International Index of Erectile Function (IIEF).

Results: ED prevalence was 76%. ED prevalence was lower in G1 vs. G3 (22 vs.65%). G2 ED rate [55%, P < 0.0001] IIEF = 24 (17-29) & Gensini's scores-21 (12.5-32) were significantly different from G1 and similar to G3, ED in ACS differs according to the extent of CAD. G3 patients who had ED symptoms prior to CAD symptoms and time interval between ED and CAD symptom onset in CCS according to number of vessels. Onset of sexual dysfunction occurred before CAD onset with a mean time interval of 24 m [12-36].

Conclusion: Early diagnosis of ED, cardiovascular assessment and aggressive treatment of cardiovascular risk factors might have contributed to prevent the acute events of this patient. Patients should be systematically screened for ED as a part of periodic examination programs. This would lead to early detection of modifiable vascular risk factors, or already existing vascular disease and to prevent ED and vascular disease progression through pharmacological and life style modifications.

Fig. 1

Schematic drawing of the GENSINI score (left). The method assigns a different severity score depending on the degree of stenosis, its location (proximal, middle or distal tract) along the target vessel and the type of coronary vessel involved (left anterior descending, left CX or RCA). An example of Gensini score calculation is shown on the right part of the figure. MLCA, main left coronary artery; LAD, left anterior descending; CFx, left circumflex; RCA, right coronary artery.

Fig. 2

Prevalence of ED in the four groups of patients.

Fig. 3

Prevalence of ED in the ACS and CSA groups.