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Treatment With Phosphodiesterase 5 Inhibitors and Long-Term Outcomes in Patients Undergoing Coronary Angiography and

Sumon Roy1,2, Annette Min1, Edward O McFalls1

  • 1McGuire Veterans Administration Medical Center, Richmond, Virginia, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 27, 2025
PubMed

Insights

Phosphodiesterase 5 (PDE5) inhibitors, used for erectile dysfunction, did not increase major adverse cardiovascular events (MACE) in patients undergoing cardiac procedures. This study found no significant association between chronic PDE5 inhibitor use and adverse cardiac outcomes at one year.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • The long-term cardiovascular effects of phosphodiesterase 5 (PDE5) inhibitors are not well-established.
  • Understanding these effects is crucial for managing patients with cardiovascular disease.

Purpose of the Study:

  • To investigate the association between PDE5 inhibitor therapy and the incidence of major adverse cardiovascular events (MACE).
  • To evaluate the safety of PDE5 inhibitors in patients undergoing coronary angiography and intervention.

Main Methods:

  • A cohort of 4582 patients undergoing coronary angiography and intervention was analyzed.
  • The primary outcome was the incidence of MACE at 1 year, including urgent revascularization, myocardial infarction, heart failure admission, or all-cause death.
  • Propensity score-matched and multivariable analyses were performed.

Main Results:

  • 12.3% of patients were prescribed PDE5 inhibitors prior to the procedure.
  • The initial analysis showed a lower incidence of MACE in the PDE5 inhibitor group (30.4% vs. 36.9%, p=0.003).
  • However, propensity score-matched and multivariable analyses revealed no significant association between PDE5 inhibitor use and MACE risk (OR=0.99, p=0.86).

Conclusions:

  • Chronic PDE5 inhibitor therapy was not associated with an increased risk of 1-year MACE in veterans undergoing cardiac catheterization.
  • These findings suggest that PDE5 inhibitors may be safely used in this patient population.
  • Further research may explore the potential cardioprotective effects observed in initial analyses.
Abstract

Keywords:
cardiac catheterizationcoronary angiographymajor adverse cardiovascular eventsoutcomesphosphodiesterase 5 inhibitors

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