Erectile dysfunction indicates high risk of  heart attack

14 July 2010

A Malaysian study has found that seven out of 10 men admitted to hospital for a heart attack had erectile dysfunction (ED) in the six months prior to their admission. The results were presented at the World Congress of Cardiology (WCC) in Beijing, China, last month.

The year-long study involving 111 sexually active men at the University Malaya Medical Centre, admitted for acute ST segment elevation myocardial infarction (STEMI), demonstrated that 75.7% had experienced ED in the six months prior to being hospitalized, and all patients with a prior history of ischemic heart disease had ED (Fisher Exact Test, p=0.020). Moreover, 24.7% of the 81 sexually inactive men that were not recruited to the study reported complete ED for more than six months prior to screening.

ED and coronary artery disease (CAD) share many common risk factors and are closely related. Atherosclerosis, the root cause of CAD and ED, is a generalized inflammatory disorder that progresses at a similar rate throughout the vasculature of the body. Therefore, it is thought that ED should precede CAD since the penile arteries are considerably smaller than the coronary arteries.

"This study demonstrates that we should consider patients with evidence of ED to be of very high risk for development of future acute coronary syndromes. Interestingly, the study also found that all patients with a prior history of heart attack and ED presented with recurrent heart attacks. Therefore, we should screen and treat such patients very aggressively," said Dr. S V Ramesh, University of Malay Medical Centre, Kuala Lumpur, Malaysia.

"Moreover, men who are not sexually active should also be closely assessed as a quarter of them have complete ED which warrants treatment and this may also be a harbinger for CAD."

A total of 219 men were admitted for STEMI to the coronary care unit from April 2008 to February 2009. Of these, 192 were screened and only 111 who were sexually active within the last six months were recruited for the assessment of ED using the IIEF-5 questionnaire. Other indices studied include the cardiovascular (CV) risk factors, body measurements, blood results and coronary angiographic findings.