Association of erectile dysfunction with incident atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis (MESA).

BACKGROUND: Erectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established.

PURPOSE: To determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors.

METHODS: We studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA Exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using three models in which variables were added in a stepwise manner. In Model 3, HR was adjusted for age, race/ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate.

RESULTS: During the median follow-up of 3.8 (interquartile range, 3.5 - 4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between men with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, respectively, p < 0.01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (Model 3; HR, 1.66; 95% Confidence Interval 1.01 - 2.72, p = 0.044).

CONCLUSIONS: Among older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.