Erectile dysfunction severity as a risk predictor for coronary artery disease.

INTRODUCTION: Erectile dysfunction (ED) is now beginning to be considered as an early manifestation of a subclinical systemic vascular disorder and may be an index of subclinical coronary artery disease (CAD).

AIM: To further evaluate whether ED is a predicting factor for CAD while adjusting for other common risk factors.

METHODS: One hundred eighty-three patients with newly diagnosed and documented CAD and 134 participants without CAD were enrolled in this case-control study at our referral center. Univariate and multivariate logistic regression analysis were performed to assess the effect of classic risk factors and ED severity on CAD; calculating odds ratio (OR) and 95% confidence interval (CI). Adjustments were made for potential confounding factors including age, hypertension, diabetes, dyslipidemia, obesity, and smoking.

MAIN OUTCOME MEASURES: The prevalence of ED and the distribution of CAD risk factors (age, smoking, lipid profile, hypertension, obesity, and diabetes mellitus) were evaluated. The 5-item International Index of Erectile Function was used to evaluate the presence and the severity of ED.

RESULTS: The prevalence of ED in CAD-positive and CAD-negative groups was 88.5% and 64.2%, respectively (P < 0.05). A statistically significant difference was found for all risk factors (except total cholesterol and low-density lipoprotein levels), and also ED prevalence between studied groups. Adjusted OR for age, diabetes, hypertension, hypercholesterolemia, and smoking demonstrated a significant confounding effect. Our results also revealed a significant association between severe ED and CAD (OR: 2.22, 95% CI: 1.11-6.03; P < 0.05).

CONCLUSION: This study suggests that ED could be considered as a surrogate marker which can predict the occurrence of CAD, and severe ED could be regarded as an independent risk predictor in addition to the established ones.