Erectile Dysfunction and Coronary Artery Disease: An Association of Higher Risk in Younger Men

Authors

  • Charles E. Riedner MD, PhD,

    Corresponding author
    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Medical Sciences, Porto Alegre, Brazil;
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  • Ernani L. Rhoden MD, PhD,

    1. Universidade Federal de Ciências da Saude de Porto Alegre (UFCSPA)—Department of Surgery/Division of Urology, Porto Alegre, Brazil;
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  • Sandra C. Fuchs MD, PhD,

    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Cardiology, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;
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  • Marco V. Wainstein MD, PhD,

    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Cardiology, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;
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  • Sandro C. Gonçalves MD, PhD,

    1. Hospital de Clinicas de Porto Alegre, Division of Cardiology, Porto Alegre, Brazil;
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  • Rodrigo V. Wainstein,

    1. Hospital de Clinicas de Porto Alegre, Division of Cardiology, Porto Alegre, Brazil;
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  • Alexandre Zago MD, PhD,

    1. Hospital de Clinicas de Porto Alegre, Division of Cardiology, Porto Alegre, Brazil;
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  • Fernando Bourscheit MD,

    1. Universidade Federal do Rio Grande do Sul, School of Medicine, Porto Alegre, Brazil
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  • Natan Katz MD,

    1. Universidade Federal do Rio Grande do Sul, School of Medicine, Porto Alegre, Brazil
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  • Alcides J. Zago MD, PhD,

    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Cardiology, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;
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  • Jorge P. Ribeiro MD, PhD,

    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Cardiology, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;
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  • Flávio D. Fuchs MD, PhD

    1. Universidade Federal do Rio Grande do Sul—Postgraduate Studies Program in Cardiology, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil;
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Charles Riedner, MD, PhD, Universidade Federal do Rio Grande do Sul- Postgraduate Studies Program in Medical Sciences, Av Mariland 450, Porto Alegre 90650090, Brazil. Tel: (555) 132-28-9887; Fax: +55-51-33598420; E-mail: charlesriedner@yahoo.com.br

ABSTRACT

Introduction.  The association between erectile dysfunction (ED) and coronary artery disease (CAD) has been described in various settings, but it is unclear if there is an independent interaction with age.

Aim.  To investigate the interaction of age in the association between ED and CAD.

Methods.  This case-control study was conducted among 242 patients referred for elective coronary angiography. One hundred fourteen patients with significant CAD were identified as cases and 128 controls without significant CAD. ED was evaluated by the erectile function domain of the International Index of Erectile Function (IIEF) questionnaire, determined by a score ≤25 points.

Main Outcome Measures.  Significant CAD was based on stenosis of 50% or greater in the diameter in at least one of the major epicardial vessels or their branches. The analysis was conducted in the whole sample and according to the age strata, controlling for the effects of cardiovascular risk factors, testosterone, and C-reactive protein.

Results.  Patients had on average 58.3 ± 8.9 years. CAD and ED were associated exclusively in patients younger than 60 years (ED in 68.8% of patients with CAD vs. 46.7% of patients without CAD, P = 0.009). The association was independent of cardiovascular risk factors, testosterone and C-reactive protein (risk ratio 2.3, 95% confidence interval from 1.04 to 5.19). Severity of CAD was higher in patients younger than 60 years with ED.

Conclusions.  Men with less than 60 years of age who report ED presented a higher risk of having chronic CAD and more severe disease diagnosed by coronary angiography. Riedner CE, Rhoden EL, Fuchs SC, Wainstein MV, Gonçalves SC, Wainstein RV, Zago A, Bourscheit F, Katz N, Zago AJ, Ribeiro JP, and Fuchs FD. Erectile dysfunction and coronary artery disease: An association of higher risk in younger men. J Sex Med 2011;8:1445–1453.

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