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Charalambos Vlachopoulos, Konstantinos Aznaouridis, Nikolaos Ioakeimidis, Konstantinos Rokkas, Carmen Vasiliadou, Nikolaos Alexopoulos, Elli Stefanadi, Athanasios Askitis, Christodoulos Stefanadis, Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease, European Heart Journal, Volume 27, Issue 22, November 2006, Pages 2640–2648, https://doi.org/10.1093/eurheartj/ehl341
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Abstract
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-1β, and TNF-α) 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.
