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Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Association between erectile dysfunction and coronary artery disease and its severity
A Sai Ravi Shanker1, B Phanikrishna, C Bhaktha Vatsala Reddy
1Cardiologist, Department of Cardiology, Narayana Medical College, Chinta Reddy Palem, Nellore 524003, Andhra Pradesh, India.
Insights
Erectile dysfunction (ED) affects 76% of coronary artery disease (CAD) patients, with severity linked to vessel involvement. Early ED screening aids cardiovascular health by identifying risk factors.
Area of Science:
- Cardiology
- Urology
- Vascular Health
Background:
- Coronary artery disease (CAD) is a significant cardiovascular condition.
- Erectile dysfunction (ED) is a common comorbidity in patients with cardiovascular disease.
- The relationship between ED severity and CAD extent requires further investigation.
Purpose of the Study:
- To determine the prevalence of ED in patients with CAD.
- To explore the correlation between ED severity and the extent of coronary artery involvement.
- To establish the time interval between the onset of ED and CAD symptoms.
Main Methods:
- 240 patients with CAD were categorized into three groups based on vessel involvement (1VD, 2-3VD, CSA).
- A control group of 60 patients with suspected CAD and normal coronary arteries was included.
- ED was assessed using the International Index of Erectile Function (IIEF) and Gensini's scores.
Main Results:
- A high prevalence of ED (76%) was observed in the CAD patient cohort.
- ED prevalence varied significantly with CAD extent, being lower in one-vessel disease (22%) compared to chronic stable angina (65%).
- ED onset preceded CAD symptom onset by a mean interval of 24 months, suggesting a common vascular etiology.
Conclusions:
- ED is a prevalent condition in CAD patients, with severity correlating to the extent of coronary artery disease.
- Systematic ED screening in routine examinations can facilitate early detection of cardiovascular risk factors.
- Proactive management of ED and cardiovascular risk factors is crucial for preventing disease progression and acute cardiovascular events.
Background/Aims:
To investigate the prevalence of erectile dysfunction (ED) in patients with coronary artery disease (CAD), its relationship between the severity of ED and the extent of coronary vessel involvement and to register the mean time interval between them.
Methods:
240 patients with CAD divided into three age-matched groups: Group 1 (n = 60), ACS with one-vessel disease (1VD); group 2 (n = 60), ACS with 2,3VD; group 3 (n = 60), CSA. Control group (C, n = 60) was composed of patients with suspected CAD who were found to have entirely normal coronary arteries by angiography. ED as any value <26 according to the Gensini's scores and according to the International Index of Erectile Function (IIEF).
Results:
ED prevalence was 76%. ED prevalence was lower in G1 vs. G3 (22 vs.65%). G2 ED rate [55%, P < 0.0001] IIEF = 24 (17-29) & Gensini's scores-21 (12.5-32) were significantly different from G1 and similar to G3, ED in ACS differs according to the extent of CAD. G3 patients who had ED symptoms prior to CAD symptoms and time interval between ED and CAD symptom onset in CCS according to number of vessels. Onset of sexual dysfunction occurred before CAD onset with a mean time interval of 24 m [12-36].
Conclusion:
Early diagnosis of ED, cardiovascular assessment and aggressive treatment of cardiovascular risk factors might have contributed to prevent the acute events of this patient. Patients should be systematically screened for ED as a part of periodic examination programs. This would lead to early detection of modifiable vascular risk factors, or already existing vascular disease and to prevent ED and vascular disease progression through pharmacological and life style modifications.
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