AIMS: Erectile dysfunction (ED) confers an independent cardiovascular risk. We investigated the role of low-grade inflammation and endothelial dysfunction in ED patients with or without coronary artery disease (CAD). METHODS AND RESULTS: We evaluated 141 men (age 58.8 years) for ED and CAD through a rigourous investigation (including coronary angiography to reveal occult CAD). Blood levels of inflammatory (hsCRP, IL-6, IL-1beta, and TNF-alpha) and endothelial-prothrombotic markers/mediators (vWF, tPA, PAI-1, and fibrinogen) were significantly increased in ED patients and correlated negatively with sexual performance. ED was associated with higher levels of these substances (except for IL-6) on top of CAD alone. For most substances, the unfavourable impact of ED alone was not significantly different than the impact of CAD alone. In multivariable models, these markers/mediators predicted independently ED presence. In our population, the negative predictive value of the combination of fibrinogen <225 mg/dL with IL-6 <1.24 pg/mL for excluding ED was 91.7% (95% CI: 61.5-99.8). CONCLUSION: ED is associated with increased inflammatory and endothelial-prothrombotic activation in men with or without CAD. ED confers an incremental unfavourable impact on the circulating levels of these markers/mediators when combined with CAD. These findings have implications for increased cardiovascular risk in ED patients.
AIMS: Erectile dysfunction (ED) confers an independent cardiovascular risk. We investigated the role of low-grade inflammation and endothelial dysfunction in ED patients with or without coronary artery disease (CAD). METHODS AND RESULTS: We evaluated 141 men (age 58.8 years) for ED and CAD through a rigourous investigation (including coronary angiography to reveal occult CAD). Blood levels of inflammatory (hsCRP, IL-6, IL-1beta, and TNF-alpha) and endothelial-prothrombotic markers/mediators (vWF, tPA, PAI-1, and fibrinogen) were significantly increased in ED patients and correlated negatively with sexual performance. ED was associated with higher levels of these substances (except for IL-6) on top of CAD alone. For most substances, the unfavourable impact of ED alone was not significantly different than the impact of CAD alone. In multivariable models, these markers/mediators predicted independently ED presence. In our population, the negative predictive value of the combination of fibrinogen <225 mg/dL with IL-6 <1.24 pg/mL for excluding ED was 91.7% (95% CI: 61.5-99.8). CONCLUSION: ED is associated with increased inflammatory and endothelial-prothrombotic activation in men with or without CAD. ED confers an incremental unfavourable impact on the circulating levels of these markers/mediators when combined with CAD. These findings have implications for increased cardiovascular risk in ED patients.
Authors: Yoshihiro Tanaka; Joshua D Bundy; Norrina B Allen; S M Iftekhar Uddin; David I Feldman; Erin D Michos; Susan R Heckbert; Philip Greenland Journal: Am J Med Date: 2019-11-16 Impact factor: 4.965
Authors: Fernando S Carneiro; Lashon C Sturgis; Fernanda R C Giachini; Zidonia N Carneiro; Victor V Lima; Brandi M Wynne; Sebastian San Martin; Michael W Brands; Rita C Tostes; R Clinton Webb Journal: J Sex Med Date: 2009-01 Impact factor: 3.802
Authors: Brant A Inman; Jennifer L St Sauver; Debra J Jacobson; Michaela E McGree; Ajay Nehra; Michael M Lieber; Véronique L Roger; Steven J Jacobsen Journal: Mayo Clin Proc Date: 2009-02 Impact factor: 7.616
Authors: Fernando S Carneiro; Saiprazad Zemse; Fernanda R C Giachini; Zidonia N Carneiro; Victor V Lima; R Clinton Webb; Rita C Tostes Journal: J Sex Med Date: 2009-03 Impact factor: 3.802