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Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity

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Abstract

Objectives

The aim of this prospective study is to evaluate patients with erectile dysfunction (ED) in terms of coronary artery calcium (CAC) levels assessed by multidetector computed tomography (MDCT) and to find out if ED severity may predict coronary heart disease risk.

Patients and method

Sixty men with a mean age of 55.7 (41–77) years with ED and 23 men with a mean age of 53.2 (39–76) years without ED, who admitted to our clinic between January 2005 and December 2005, were included in the study. All patients answered the standard International Index of Erectile Function (IIEF) forms, and were classified into four groups as mild, moderate, severe ED and no ED. CAC levels were assessed by MDCT protocol. CAC levels and IIEF scores were analyzed within each group.

Results

Pearson correlation test demonstrated significant negative correlation between IIEF score and CAC score (r = −497; P < 0.0001). CAC scores increased significantly with regard to IIEF scores decrease: IIEF 1–10 (n = 18), mean CAC: 557.7; IIEF 11–16 (n = 13), mean CAC: 541.3; IIEF 17–25 (n = 29), mean CAC: 84.6; and IIEF ≥ 26 [n = 23 (Control group)], mean CAC: 10.1. The difference between the mean CAC scores of these four groups was statistically significant (P < 0.0001). When we took the cut-off value for IIEF score 26 we observed significantly higher CAC scores at the group of IIEF < 26 (mean 325.5 vs 10.1; P < 0.0001).

Conclusion

We observed positive correlation with ED severity and CAC levels. Therefore, we think that detection and quantification of preclinical coronary artery disease by CAC scoring with a non-invasive method might have a great potential for early cardiac preventive measures.

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References

  1. NIH Consensus Conference Impotence (1993) NIH development panel on impotence. JAMA 270(1):83–90

    Article  Google Scholar 

  2. Ayta IA, McKinlay JB, Krane RJ et al (1999) The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 84(1):50–56

    Article  PubMed  CAS  Google Scholar 

  3. Sullivan ME, Keoghane SR, Miller MA (2001) Vascular risk factors and erectile dysfunction. BJU Int 87:838–845

    Article  PubMed  CAS  Google Scholar 

  4. Kloner RA, Speakman M (2002) Erectile dysfunction and atherosclerosis. Curr Atheroscler Rep 4:397–401

    Article  PubMed  Google Scholar 

  5. Feldman HA, Goldstein I, Hatzichristou DG et al (1999) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 151:54–61

    Google Scholar 

  6. Virag R, Bouilly P, Frydman D (1985) Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet 1:181–184

    Article  PubMed  CAS  Google Scholar 

  7. Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I et al (2001) Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study (with discussion). J Urol 166:569–575

    Article  PubMed  CAS  Google Scholar 

  8. Blanker MH, Bohnen AM, Groeneveld FP et al (2001) Correlates for erectile and ejaculatory dysfunction in older Dutch men: a communitybased study. J Am Geriatr Soc 49(4):436–442

    Article  PubMed  CAS  Google Scholar 

  9. Solomon H, Man JW, Jackson G (2003) Erectile dysfunction and the cardiovascular patient: endotelial dysfunction is the common denominator. Heart 89:251–253

    Article  PubMed  CAS  Google Scholar 

  10. Mass R, Schwedhelem E, Albseier J et al (2002) The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular function. Vasc Med 7:213–225

    Article  Google Scholar 

  11. Greenland P, LaBree L, Azen SP et al (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215

    Article  PubMed  CAS  Google Scholar 

  12. Detrano RC, Doherty TM, Davies MJ et al (2000) Predicting coronary events with coronary calcium: pathophysiologic and clinical problems. Curr Probl Cardiol 25:374–402

    Article  PubMed  CAS  Google Scholar 

  13. Schmermund A, Möhlenkamp S, Erbel R (2003) Coronary artery calcium and its relationship to coronary artery disease. Cardiol Clin 21(4):521–534

    Article  PubMed  Google Scholar 

  14. Newman AB, Naydeck BL, Sutton-Tyrrell K et al (2002) Relationship between coronary artery calcification and other measures of subclinical cardiovascular disease in older adults. Arterioscler Thromb Vasc Biol 22:1674–1679

    Article  PubMed  CAS  Google Scholar 

  15. Cappelleri JC, Rosen RC, Smith MD et al (1999) Diagnostic evaluation of the erectile function domain of the ınternational index of erectile function. Urology 54:346–351

    Article  PubMed  CAS  Google Scholar 

  16. Agatston AS, Janowitz WR, Hildner FJ et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832

    Article  PubMed  CAS  Google Scholar 

  17. Rumberger J, Brundage B, Rader D et al (1999) Electron beam computed tomography coronary calcium scanning: a review and guidlines for use in asymptomatic persons. Mayo Clin Proc 74:243–252

    Article  PubMed  CAS  Google Scholar 

  18. Jackson G, Rosen RC, Kloner RA et al (2006) The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 3(1):28–36

    Article  PubMed  CAS  Google Scholar 

  19. Montorsi P, Montorsi F, Schulman C (2003) Is erectile dysfunction the tip of the iceberg of a systemic disorder? Eur Urol 44:352–354

    Article  PubMed  Google Scholar 

  20. Montorsi P, Ravagnani M, Galli S et al (2004) Common grounds for erectile dysfunction and coronary artery disease. Curr Opin Urol 14:361–365

    Article  PubMed  Google Scholar 

  21. Solomon H, Man JW, Wierzbicki AS et al (2002) Relation of erectile dysfunction to angiographic artery disease. Am J Cardiol 91:230–231

    Article  Google Scholar 

  22. Montorsi F, Briganti A, Salonia A et al (2003) 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. Eur Urol 44:360–365

    Article  PubMed  Google Scholar 

  23. Fung MM, Bettencourt R, Barrett-Connor E (2004) Heart disease risk factors predict erectile dysfunction 25 years later (the Rancho Bernardo Study). Am J Cardiol 43:1405–1411

    Article  Google Scholar 

  24. Kondos GT, Hoff JA, Sevrukov A et al (2003) Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 107:2571–2576

    Article  PubMed  Google Scholar 

  25. Shemesh J, Morag-Koren N, Goldbourt U et al (2004) Coronary calcium by spiral computed tomography predicts cardiovascular events in high-risk hypertensive patients. J Hypertens 22:605–610

    Article  PubMed  CAS  Google Scholar 

  26. Chiurlia E, D’Amico R, Ratti C et al (2005) Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol 46(8):1503–1506

    Article  PubMed  Google Scholar 

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Correspondence to Omer Gulpinar.

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Yaman, O., Gulpinar, O., Hasan, T. et al. Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 40, 117–123 (2008). https://doi.org/10.1007/s11255-007-9293-8

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  • DOI: https://doi.org/10.1007/s11255-007-9293-8

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