Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease.
OBJECTIVE
Erectile dysfunction (ED) confers an independent cardiovascular risk. We investigated the role of low-grade inflammation and endothelial dysfunction in ED patients with or without coronary artery disease (CAD).


RESULTS
We evaluated 141 men (age 58.8 years) for ED and CAD through a rigourous investigation (including coronary angiography to reveal occult CAD). Blood levels of inflammatory (hsCRP, IL-6, IL-1beta, and TNF-alpha) and endothelial-prothrombotic markers/mediators (vWF, tPA, PAI-1, and fibrinogen) were significantly increased in ED patients and correlated negatively with sexual performance. ED was associated with higher levels of these substances (except for IL-6) on top of CAD alone. For most substances, the unfavourable impact of ED alone was not significantly different than the impact of CAD alone. In multivariable models, these markers/mediators predicted independently ED presence. In our population, the negative predictive value of the combination of fibrinogen <225 mg/dL with IL-6 <1.24 pg/mL for excluding ED was 91.7% (95% CI: 61.5-99.8).


CONCLUSIONS
ED is associated with increased inflammatory and endothelial-prothrombotic activation in men with or without CAD. ED confers an incremental unfavourable impact on the circulating levels of these markers/mediators when combined with CAD. These findings have implications for increased cardiovascular risk in ED patients.
Vlachopoulos
Charalambos
C
Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Kerassoundos 17, Athens 11528, Greece. cvlachop@otenet.gr
Aznaouridis
Konstantinos
K
Ioakeimidis
Nikolaos
N
Rokkas
Konstantinos
K
Vasiliadou
Carmen
C
Alexopoulos
Nikolaos
N
Stefanadi
Elli
E
Askitis
Athanasios
A
Stefanadis
Christodoulos
C
D015415:Biomarkers / Q000378:metabolism; D003324:Coronary Artery Disease / Q000150:complications* / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000378:metabolism; D006801:Humans; D018783:Impotence, Vasculogenic / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D016207:Cytokines