Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

Sexual Medicine - Tập 4 - Trang e127-e134 - 2016
Amr Abdelhamed1,2, Shin-ichi Hisasue1, Essam A. Nada2, Ali M. Kassem3, Mohammed Abdel-Kareem2, Shigeo Horie1
1Department of Urology, Juntendo University, Tokyo, Japan
2Department of Dermatology, Venereology, and Andrology, Sohag University, Nasr City, Sohag, Egypt
3Department of Internal Medicine, Sohag University, Nasr City, Sohag, Egypt

Tóm tắt

Abstract Introduction Erectile dysfunction (ED) can precede coronary artery disease. In addition, silent myocardial ischemia (SMI) is more common in diabetic patients and is a strong predictor of cardiac events and death. Aim To evaluate the presence of SMI in patients with diabetes and ED using multidetector computed tomographic coronary angiography (MDCT-CA). Methods This study evaluated patients with diabetes and ED without any history of cardiac symptoms or signs. Erectile function was evaluated with the Sexual Health Inventory for Men score, erection hardness score (EHS), and maximal penile circumferential change by an erectometer. MDCT-CA was used for the detection of coronary artery stenosis. Main Outcome Measures Sexual Health Inventory for Men score, EHS, maximal penile circumferential change, and coronary artery stenosis by MDCT-CA. Results Of 20 patients (mean age = 61.45 ± 10.7 years), MDCT-CA showed coronary artery stenosis in 13 (65%) in the form of one-vessel disease (n = 6, 30%), two-vessel disease (n = 2, 10%), and three-vessel disease (n = 5, 25%). Fifty percent of patients showed at least 50% vessel lumen obstruction of the left anterior descending coronary artery, which was the most commonly affected vessel (55%). Fifteen percent (3 of 20) of patients had greater than 90% stenosis, and two of them underwent an immediate coronary angioplasty with stenting to prevent myocardial infarction. Maximum coronary artery stenosis was positively correlated with age (P = 0.016, r = 0.529) and negatively correlated with EHS (P = .046, r = −0.449). Multivariate regression analysis using age and EHS showed that age was the only independent predictor of SMI (P = .04). Conclusion MDCT-CA can be a useful tool to identify SMI in diabetic patients with ED, especially in those of advanced age and/or with severe ED.

Tài liệu tham khảo

Shaw, 2010, Global estimates of the prevalence of diabetes for 2010 and 2030, Diabetes Res Clin Pract, 87, 4, 10.1016/j.diabres.2009.10.007 Centers for Disease Control and Prevention, 2011, National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011, 1 Roger, 2012, Heart disease and stroke statistics—2012 update: a report from the American Heart Association, Circulation, 125, e2 Fowler, 2008, Microvascular and macrovascular complications of diabetes, Clin Diabetes, 26, 77, 10.2337/diaclin.26.2.77 Gandaglia, 2014, A systematic review of the association between erectile dysfunction and cardiovascular disease, Eur Urol, 65, 968, 10.1016/j.eururo.2013.08.023 Malavige, 2009, Erectile dysfunction in diabetes mellitus, J Sex Med, 6, 1232 Yamada, 2012, Erectile dysfunction and cardiovascular events in diabetic men: a meta-analysis of observational studies, PLoS One, 7, e43673, 10.1371/journal.pone.0043673 Corona, 2013, The identification of prediabetes condition with ARIC algorithm predicts long-term CV events in patients with erectile dysfunction, J Sex Med, 10, 1114 Corona, 2008, Penile Doppler ultrasound in patients with erectile dysfunction (ED): role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease, J Sex Med, 5, 2623 Tabibiazar, 2003, Silent ischemia in people with diabetes: a condition that must be heard, Clin Diabetes, 21, 5, 10.2337/diaclin.21.1.5 Valensi, 2011, Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature, Arch Cardiovasc Dis, 104, 178, 10.1016/j.acvd.2010.11.013 Fox, 2015, Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association, Diabetes Care, 38, 1777, 10.2337/dci15-0012 Davis, 2013, Prognostic significance of silent myocardial infarction in newly diagnosed type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS) 79, Circulation, 127, 980, 10.1161/CIRCULATIONAHA.112.000908 Scheidt-Nave, 1990, Resting electrocardiographic abnormalities suggestive of asymptomatic ischemic heart disease associated with non–insulin-dependent diabetes mellitus in a defined population, Circulation, 81, 899, 10.1161/01.CIR.81.3.899 Doobay, 2005, Sensitivity and specificity of the ankle-brachial index to predict future cardiovascular outcomes: a systematic review, Arterioscler Thromb Vasc Biol, 25, 1463, 10.1161/01.ATV.0000168911.78624.b7 1997, Prevalence of unrecognized silent myocardial ischemia and its association with atherosclerotic risk factors in noninsulin-dependent diabetes mellitus. Milan Study on Atherosclerosis and Diabetes (MiSAD) Group, Am J Cardiol, 79, 134, 10.1016/S0002-9149(96)00699-6 Young, 2009, Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial, JAMA, 301, 1547, 10.1001/jama.2009.476 Lièvre, 2011, Detection of silent myocardial ischemia in asymptomatic patients with diabetes: results of a randomized trial and meta-analysis assessing the effectiveness of systematic screening, Trials, 12, 23, 10.1186/1745-6215-12-23 Elkeles, 2008, Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study, Eur Heart J, 29, 2244, 10.1093/eurheartj/ehn279 Scholte, 2008, Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes, Heart, 94, 290, 10.1136/hrt.2007.121921 Scholte, 2006, Screening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: combined use of stress myocardial perfusion imaging and coronary calcium scoring, J Nucl Cardiol, 13, 11, 10.1016/j.nuclcard.2005.11.002 Khan, 2011, Comparison of radiation dose and image quality: 320-MDCT versus 64-MDCT coronary angiography, AJR Am J Roentgenol, 197, 163, 10.2214/AJR.10.5250 Meijer, 2008, Meta-analysis of 40- and 64-MDCT angiography for assessing coronary artery stenosis, AJR Am J Roentgenol, 191, 1667, 10.2214/AJR.07.4022 Nishioka, 2010, Predictors of coronary heart disease in Japanese patients with type 2 diabetes: screening for coronary artery stenosis using multidetector computed tomography, J Diabetes Invest, 1, 50, 10.1111/j.2040-1124.2009.00003.x Andreini, 2013, Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries, Diabetes Care, 36, 1834, 10.2337/dc12-2123 Yaman, 2008, Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity, Int Urol Nephrol, 40, 117, 10.1007/s11255-007-9293-8 Jackson, 2013, Erectile dysfunction and asymptomatic coronary artery disease: frequently detected by computed tomography coronary angiography but not by exercise electrocardiography, Int J Clin Pract, 67, 1159, 10.1111/ijcp.12275 Umul, 2014, Relationship between erectile dysfunction and silent coronary artery disease: detection with multidetector computed tomography coronary angiography, Urol Int, 92, 310, 10.1159/000351750 2013, Standards of medical care in diabetes—2013, Diabetes Care, 36, S11 Cappelleri, 2005, The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience, Int J Impot Res, 17, 307, 10.1038/sj.ijir.3901327 Mulhall, 2007, Validation of the erection hardness score, J Sex Med, 4, 1626 Suzuki, 2001, The correlation between penile tumescence measured by the erectometer and penile rigidity by the RigiScan, Int J Urol, 8, 594, 10.1046/j.1442-2042.2001.00390.x Matsuda, 2014, Correlation between erection hardness score and nocturnal penile tumescence measurement, J Sex Med, 11, 2272 Raff, 2009, SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography, J Cardiovasc Comput Tomogr, 3, 122, 10.1016/j.jcct.2009.01.001 Montorsi, 2005, The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease, Am J Cardiol, 96, 19m, 10.1016/j.amjcard.2005.07.006 Guo, 2010, Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies, J Sex Med, 7, 2805 Batty, 2010, Erectile dysfunction and later cardiovascular disease in men with type 2 diabetes: prospective cohort study based on the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) trial, J Am Coll Cardiol, 56, 1908, 10.1016/j.jacc.2010.04.067 Montorsi, 2006, Association between erectile dysfunction and coronary artery disease: matching the right target with the right test in the right patient, Eur Urol, 50, 721, 10.1016/j.eururo.2006.07.015 Kyto, 2014, Association of age and gender with anterior location of STEMI, Int J Cardiol, 176, 1161, 10.1016/j.ijcard.2014.07.254 Miner, 2012, Prognostic utility of erectile dysfunction for cardiovascular disease in younger men and those with diabetes, Am Heart J, 164, 21, 10.1016/j.ahj.2012.04.006 Meena, 2009, Association between erectile dysfunction and cardiovascular risk in individuals with type-2 diabetes without overt cardiovascular disease, Int J Diabetes Dev Ctries, 29, 150, 10.4103/0973-3930.57345 Heruti, 2007, Erectile dysfunction severity might be associated with poor cardiovascular prognosis in diabetic men, J Sex Med, 4, 465 Jackson, 2010, Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus, Int J Clin Pract, 64, 848, 10.1111/j.1742-1241.2010.02410.x Gandaglia, 2013, Erectile dysfunction as a cardiovascular risk factor in patients with diabetes, Endocrine, 43, 285, 10.1007/s12020-012-9780-2 González-Juanatey, 2009, [Erectile dysfunction as a marker of silent cardiovascular disease in type-2 diabetic patients in Spain. The DIVA (DIabetes and VAscular disease) study], Med Clin, 132, 291, 10.1016/j.medcli.2008.06.009 Gazzaruso, 2004, Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients, Circulation, 110, 22, 10.1161/01.CIR.0000133278.81226.C9 Gazzaruso, 2008, Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease: a potential protective role for statins and 5-phosphodiesterase inhibitors, J Am Coll Cardiol, 51, 2040, 10.1016/j.jacc.2007.10.069 García-Malpartida, 2011, Relationship between erectile dysfunction and silent myocardial ischemia in type 2 diabetic patients with no known macrovascular complications, J Sex Med, 8, 2606 Gazzaruso, 2011, Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes, Endocrine, 40, 273, 10.1007/s12020-011-9523-9 Ma, 2008, Erectile dysfunction predicts coronary heart disease in type 2 diabetes, J Am Coll Cardiol, 51, 2045, 10.1016/j.jacc.2008.02.051 Shimabukuro, 2015, Risk stratification of coronary artery disease in asymptomatic diabetic subjects using multidetector computed tomography, Circ J, 79, 2422, 10.1253/circj.CJ-15-0325
Thông tin
Thông tin xuất bản

Sexual Medicine

Tập 4

e127-e134

Thông tin tác giả