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Erectile dysfunction severity as a predictor of left main and/or three-vessel disease in acute coronary syndrome
Mohammad M Al-Daydamony1, Ahmad Shawky1, Ahmad Tharwat1
1Cardiology Department, Faculty of Medicine, Zagazig University, Egypt.
Insights
Moderate to severe erectile dysfunction (ED) in acute coronary syndrome (ACS) patients may indicate significant coronary artery disease, specifically left main and/or three-vessel disease (LM/3VD). An International Index of Erectile Function (IIEF) score below 17 is an independent predictor of LM/3VD.
Area of Science:
- Cardiology
- Urology
- Internal Medicine
Background:
- Coronary artery disease (CAD) is a major cause of death and morbidity.
- Early identification of high-risk patients with left main and/or three-vessel disease (LM/3VD) within acute coronary syndrome (ACS) is crucial.
- A link between erectile dysfunction (ED) and cardiovascular disease has been previously observed.
Purpose of the Study:
- To investigate whether the severity of ED can predict the presence of LM/3VD in patients experiencing ACS.
- To establish the predictive value of ED severity for significant coronary artery disease in ACS patients.
Main Methods:
- Eighty-five male ACS patients underwent clinical assessment, International Index of Erectile Function (IIEF) scoring, and coronary angiography.
- The Gensini score was used to quantify CAD severity.
- Patients were stratified into mild/no ED (IIEF ≥17) and moderate/severe ED (IIEF <17) groups.
Main Results:
- Patients with moderate/severe ED (IIEF <17) exhibited a significantly higher prevalence of LM CAD (18.4% vs 4.3%), 3VD (39.5% vs 17%), and LM/3VD (55.3% vs 21.3%) compared to those with mild/no ED.
- The mean Gensini score was substantially higher in the moderate/severe ED group (34.1 vs 23.5).
- An IIEF score <17, along with age, heart rate, Killip class >1, and specific ECG findings (aVR), independently predicted LM/3VD.
Conclusions:
- Moderate to severe ED in ACS patients is associated with increased CAD severity (higher Gensini score) and a greater likelihood of LM/3VD.
- An IIEF score <17 serves as an independent predictor for LM/3VD in this patient population.
Background:
Coronary artery disease (CAD) is a leading cause of morbidity and death. Early diagnosis of patients with left main and/or three-vessel disease (LM/3VD) among acute coronary syndrome (ACS) patients is beneficial. The relation between erectile dysfunction (ED) and cardiovascular diseases was previously noticed. The aim of our work was to find out if the severity of ED could predict the presence of LM/3VD in ACS patients.
Patients And Methods:
Eighty-five male patients with ACS were included in the study. Clinical assessment, estimation of international index of erectile function (IIEF) score, and coronary angiography were performed in all patients. Gensini score was calculated to assess the severity of CAD. Based on IIEF score, the patients were divided into two groups: Group 1: patients with mild or no ED (IIEF score ≥17), Group 2: patients with moderate or severe ED (IIEF score <17).
Results:
Patients with IIEF score <17 had significantly higher prevalence of LM CAD (4.3% versus 18.4%, p=0.035), 3VD (17% versus 39.5%, p=0.021) and LM/3VD (21.3% versus 55.3%, p=0.0012), as well as higher mean Gensini score (23.5±10.8 versus 34.1±12.7, p=0.0001). The independent predictors of LM/3VD in order of significance were: age, heart rate, IIEF <17, Killip class >1, and ST-depression or ST-elevation in lead aVR ≥1mV. There was a significant negative correlation between IIEF score and Gensini score (r=-0.383, p=0.0003).
Conclusion:
The presence of moderate or severe ED in men with ACS is associated with higher Gensini score and more incidence of LM/3VD. IIEF score <17 was an independent predictor of LM/3VD.
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