Independent Determinants of Coronary Artery Disease in Erectile Dysfunction Patients

Authors

  • Shih-Tai Chang MD,

    1. Division of Cardiology, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Chi-Ming Chu PhD,

    1. Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan;
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  • Jen-Te Hsu MD,

    1. Division of Cardiology, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Ju-Feng Hsiao MD,

    1. Division of Cardiology, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Chang-Min Chung MD,

    1. Division of Cardiology, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Cheng Ho MD,

    1. Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan;
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  • Yun-Shing Peng MD,

    1. Division of Endocrinology and Metabolism, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Pao-Yin Chen MD,

    1. Division of Endocrinology and Metabolism, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan;
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  • Jia-Jen Shee MD

    Corresponding author
    1. Division of Urology, Chiayi Chang Gung Memorial Hospital; Chiayi School, Chang Gung Institute of Technology, Chai Yi Hsien, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Jia-Jen Shee, MD, Division of Urology, Chiayi Chang Gung Memorial Hospital, 6, Sec. West Chai-Pu Road, Pu-TZ City, Chai Yi Hsien, Taiwan. Tel: 886-5-3621000 Ext 2854; Fax: 886-5-3623005; E-mail: cst1234567@yahoo.com.tw, accept@adm.cgmh.org.tw

ABSTRACT

Introduction.  There is growing evidence of a link between erectile dysfunction (ED) and coronary artery disease (CAD).

Aims.  The purpose of this study was to explore the independent determinants of CAD in ED outpatients.

Methods.  This study enrolled 243 patients, ranging in age from 21 to 81 years old, suffering from ED as diagnosed by the International Index of Erectile Function (IIEF) scores. All patients underwent exercise stress tests or thallium-201 single-photon emission computed tomography perfusion imagings. Based on examination results, patients were divided into study (22 patients with a positive finding) and control groups (221 patients with a negative finding).

Main Outcome Measures.  The differences of demographic characteristics, biochemical profiles, pro-inflammatory and inflammatory markers, and echocardiographic characteristics between study and control group were compared.

Results.  The age, presence of DM and current smoking status were significant high in the study group. A significant lower high-density lipoprotein (HDL) cholesterol level, a higher percentage of HDL cholesterol level < 40 mg/dL, and a higher apo-lipoprotein B/A1, high sensitive C-reactive protein (hs-CRP) and homocysteine found in the study group. The Framingham cardiac risk scores, the ratio of mitral inflow velocity to early diastolic velocity in the annulus derived by tissue Doppler imaging (E/Et), the ratio of E/Et ≥ 15, the value of carotid intima-media thickness (IMT), and IMT ≥ 1 mm were higher in study group than in the control group. In stepwise multiple logistic regression analysis, a high waist-to-hip ratio (WHR), high IMT, high E/Et, hs-CRP levels, LDL cholesterol ≥ 130 mg/dL, smoking status, and the presence of DM and metabolic syndrome (MS) were independent determinants of CAD in ED patients.

Conclusions.  This study first shows the independent determinants of CAD in ED outpatients. This novel finding may improve the screening of low-risk ED patients for CAD. Chang S-T, Chu C-M, Hsu J-T, Hsiao J-F, Chung C-M, Ho C, Peng Y-S, Chen P-Y, and Shee J-J. Independent determinants of coronary artery disease in erectile dysfunction patients. J Sex Med 2010;7:1478–1487.

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