Document Detail

Erectile dysfunction and silent coronary artery disease: abnormal computed tomography coronary angiogram in the presence of normal exercise ECGs.
MedLine Citation:
PMID:  18479289     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Erectile dysfunction (ED) and coronary artery disease (CAD) frequently coexist. ED may be present in the absence of cardiac symptoms 3-5 years before a coronary event. Exercise electrocardiography may identify flow-limiting CAD but cardiac computed tomography (CT) may identify early non-calcified plaque disease potentially vulnerable to rupture precipitating an acute event. METHODS: Twenty men aged 39-69 years with ED and no cardiac symptoms underwent screening for cardiovascular risk including maximal treadmill exercise testing and CT coronary angiography. ED was confirmed using the Sexual Health Inventory for Men questionnaire. FINDINGS: Eighteen had a low-density lipoprotein cholesterol > 3 mmol/l, none were diabetic and seven were hypertensive controlled on medical therapy. Coronary calcium scores were > 50 in 11 men (range: 54-1234) all of whom had angiographic CAD on CT. Nine of these had normal exercise ECGs. Four men had calcium scores of 6-17 and single plaque disease on CT. Five had normal cardiac CT studies. INTERPRETATION: Erectile dysfunction may be a predictor of subclinical non-flow limiting CAD not detectable on exercise electrocardiography. Men with organic ED and no cardiac symptoms should be considered as 'cardiac equivalents' and aggressive risk reduction therapy initiated.
G Jackson; S Padley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of clinical practice     Volume:  62     ISSN:  1742-1241     ISO Abbreviation:  Int. J. Clin. Pract.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-15     Completed Date:  2008-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9712381     Medline TA:  Int J Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  973-6     Citation Subset:  IM    
Cardiothoracic Centre, Guy's & St Thomas' NHS Hospital Trust, St Thomas' Hospital, London, UK.
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MeSH Terms
Coronary Angiography
Coronary Artery Disease / complications*,  radiography
Erectile Dysfunction / complications*
Middle Aged
Tomography, X-Ray Computed

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