Document Detail

Efficacy and limits of sildenafil citrate in patients with arterial erectile dysfunction: role of peripheral arterial disease and cardiovascular comorbidities.
MedLine Citation:
PMID:  18958348     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction (ED) was related to their peak systolic velocity (PSV), peripheral atherosclerosis, cardiovascular risk factors (RF) and/or comorbidities at low cardiovascular risk. METHODS: We enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial ED alone (group A, n = 27), ED plus atherosclerotic carotid artery (group B, n = 23), ED plus lower limb artery abnormalities (group C, n = 25), and ED plus carotid and lower limb artery abnormalities (group D, n = 22). Sildenafil efficacy (100 mg twice a week for 12 weeks) was also examined in patients with =or>3 RF, peripheral atherosclerosis and no cardiovascular comorbidities (group E, n = 20). RESULTS: Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients (77.8%), intermediate in groups B and C (65.2% and 56%) and lowest in groups D (45.4%) and E (50%), and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was negatively influenced by: =or>3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidities was positively related to atherosclerosis localization or extension (25, 35, 38 and 47 in groups A, B, C and D, respectively). CONCLUSION: Low sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.
Enzo Vicari; Mariano Malaguarnera; Sandro La Vignera; Fabio Calzavara; Carmelo Battiato; Aldo E Calogero
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian journal of andrology     Volume:  10     ISSN:  1008-682X     ISO Abbreviation:  Asian J. Androl.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-29     Completed Date:  2009-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100942132     Medline TA:  Asian J Androl     Country:  China    
Other Details:
Languages:  eng     Pagination:  847-53     Citation Subset:  IM    
Copyright Information:
(c) 2008, Asian Journal of Andrology, SIMM and SJTU. All rights reserved.
Department of Biomedical Sciences, University of Catania, Catania 95123, Italy.
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MeSH Terms
Arterial Occlusive Diseases / complications,  drug therapy*,  physiopathology
Atherosclerosis / complications
Cardiovascular Diseases / complications,  drug therapy*
Erectile Dysfunction / drug therapy*,  etiology,  physiopathology
Lower Extremity / blood supply
Middle Aged
Physical Examination
Piperazines / therapeutic use*
Purines / therapeutic use
Regional Blood Flow / physiology
Retrospective Studies
Risk Factors
Sulfones / therapeutic use*
Treatment Outcome
Vasodilator Agents / therapeutic use*
Reg. No./Substance:
0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil

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