Researchers says they 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 cardiovascular events and death among CAD diabetic patients with erectile dysfunction.

Case-control studies showed that erectile dysfunction is associated with Coronary Artery Disease in diabetic patients, but no prospective study is available.

Type 2 diabetic men (n = 291) with silent coronary artery disease 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 adverse 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. Treatment 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).

Conclusions: Our data first show that erectile dysfunction is a powerful predictor of cardiovascular morbidity and mortality in diabetic patients with silent coronary artery disease and that the treatment with statins and 5-PDE inhibitors might reduce the occurrence of MACE among coronary artery disease diabetic patients with erectile dysfunction.
Journal of the American College of Cardiology
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