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Is the History of Erectile Dysfunction a Reliable Risk Factor for New Onset Acute Myocardial Infarction? A Systematic

Ahmed Adam1,2,3, Jared McDowall4, Sunday Joseph Aigbodion4

  • 1Division of Urology, Department of Surgery, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, London, UK.

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Erectile dysfunction (ED) is a potential risk factor for new onset acute myocardial infarction (AMI). This systematic review suggests considering ED history for predicting first-time AMI events.

Keywords:
Acute coronary syndromeAcute myocardial infarctionCardiovascular diseaseCoronary artery diseaseErectile dysfunctionNon-ST-elevation myocardial infarctionST-elevation myocardial infarction

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Area of Science:

  • Cardiology
  • Men's Health
  • Preventive Medicine

Background:

  • Acute myocardial infarction (AMI) is linked to coronary atherosclerotic disease.
  • Erectile dysfunction (ED) is a known occurrence post-AMI, with interrelated pathophysiology.
  • The diagnostic value of ED as an independent risk factor for initial AMI is under-explored.

Purpose of the Study:

  • To systematically review and analyze the diagnostic predictability of erectile dysfunction (ED) as a precursor for first-time acute myocardial infarction (AMI).
  • To assess the evidence supporting ED as an early warning sign for incident cardiovascular events.

Main Methods:

  • A systematic literature search was conducted across major databases (Cochrane, Embase, PubMed, Scopus, Web of Science) up to September 2018.
  • Studies were selected based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.
  • Four relevant studies involving 573 participants were included and assessed for quality using the Critical Appraisal Skills Program tool.

Main Results:

  • Meta-analysis of four studies yielded a pooled sensitivity of 51.36% (95% CI: 47.37-55.33%) for ED predicting new onset AMI.
  • A single study reported a specificity of 76.53% (95% CI: 68.57-83.00%) for ED as a diagnostic marker.
  • These findings indicate a moderate predictive capability of ED for incident AMI.

Conclusions:

  • A history of erectile dysfunction demonstrates potential as a significant risk factor for new onset acute myocardial infarction.
  • Clinicians should consider evaluating for ED in patients at risk for cardiovascular disease.
  • Further research may refine the role of ED in cardiovascular risk stratification.