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Penile brachial index in impotent patients with coronary artery disease
1Department of Surgery, National Yang-Ming Medical College, Taipei, Taiwan.
Insights
Erectile dysfunction is common in patients with coronary artery disease, but penile brachial index (PBI) is not a reliable predictor of heart attack risk. Further research is needed to understand this complex relationship.
Area of Science:
- Cardiology
- Urology
- Vascular Medicine
Background:
- Erectile dysfunction (ED) is a common concern for patients undergoing coronary catheterization.
- The relationship between coronary artery disease (CAD) and ED requires further investigation.
Purpose of the Study:
- To assess the prevalence of ED in patients with and without CAD.
- To evaluate the penile brachial index (PBI) as a potential predictor of CAD severity and future cardiac events.
Main Methods:
- Questionnaires on sexual potency administered to 40 patients post-coronary catheterization.
- Penile Doppler ultrasonography performed in 30 patients to measure PBI.
- Correlation analysis between PBI, CAD severity, and ED symptoms.
Main Results:
- A high prevalence of ED was observed in patients with diseased coronary arteries (93.4%) compared to those with normal arteries (40%).
- Mean PBI was lower in patients with diseased coronary arteries (0.73 +/- 0.1) than in those with normal arteries (0.82 +/- 0.1), though not statistically significant (p=0.05).
- No significant correlation was found between PBI and the degree of coronary artery obstruction, including the left anterior descending artery.
Conclusions:
- ED is highly prevalent in patients with CAD.
- PBI alone is not a reliable predictor of coronary artery obstruction severity or future major thromboembolic events.
- Further research is needed to elucidate the complex interplay between cardiovascular health and erectile function.
Abstract:
From March to July 1989, a total of 40 patients, who had received coronary catheterization, answered questionnaires concerning sexual potency. In those 30 patients with a diseased coronary artery, only 2 (6.6%) had no erectile dysfunction subjectively. On the contrary, 4 of 10 (40%) patients with angiographically proven normal coronary artery complained of erectile dysfunction. Penile Doppler ultrasonography was performed in 30 patients. The mean penile brachial index (PBI) of 8 patients with a normal coronary artery was 0.82 +/- 0.1, as compared with the diseased group, 0.73 +/- 0.1 (p = 0.05). When these patients were further divided into two groups by a PBI of greater or less than 0.65, there was also no significant difference in the degree of obstruction of the three main coronary arteries between these two groups. There was no correlation between PBI and obstruction of the left anterior descending artery (r = 0.316, p = 0.689). Most of the patients (93.4%) with an abnormal coronary artery had erectile dysfunction. Nevertheless a poor correlation was noted between the PBI and the severity of coronary artery obstruction. Our study suggests that it is hard to use PBI alone as a predictor of future major thromboembolic heart attack.