Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity

Abstract

The aim of this prospective study is to evaluate patients with erectile dysfunction (ED) in terms of coronary artery calcium (CAC) levels assessed by multidetector computed tomography (MDCT) and to find out if ED severity may predict coronary heart disease risk. Sixty men with a mean age of 55.7 (41-77) years with ED and 23 men with a mean age of 53.2 (39-76) years without ED, who admitted to our clinic between January 2005 and December 2005, were included in the study. All patients answered the standard International Index of Erectile Function (IIEF) forms, and were classified into four groups as mild, moderate, severe ED and no ED. CAC levels were assessed by MDCT protocol. CAC levels and IIEF scores were analyzed within each group. Pearson correlation test demonstrated significant negative correlation between IIEF score and CAC score (r= -497; P<0.0001). CAC scores increased significantly with regard to IIEF scores decrease: IIEF 1-10 (n=18), mean CAC: 557.7; IIEF 11-16 (n=13), mean CAC: 541.3; IIEF 17-25 (n=29), mean CAC: 84.6; and IIEF >or= 26 [n=23 (Control group)], mean CAC: 10.1. The difference between the mean CAC scores of these four groups was statistically significant (P<0.0001). When we took the cut-off value for IIEF score 26 we observed significantly higher CAC scores at the group of IIEF <26 (mean 325.5 vs 10.1; P<0.0001). We observed positive correlation with ED severity and CAC levels. Therefore, we think that detection and quantification of preclinical coronary artery disease by CAC scoring with a non-invasive method might have a great potential for early cardiac preventive measures.