title: Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease.
abstract: 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.
authors.affiliation: Cardiovascular Diseases and Sexual Health Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Kerassoundos 17, Athens 11528, Greece. cvlachop@otenet.gr
authors.forename: Charalambos
authors.initials: C
authors.lastname: Vlachopoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Aznaouridis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Ioakeimidis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Rokkas
authors.forename: Carmen
authors.initials: C
authors.lastname: Vasiliadou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Alexopoulos
authors.forename: Elli
authors.initials: E
authors.lastname: Stefanadi
authors.forename: Athanasios
authors.initials: A
authors.lastname: Askitis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: 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
chemical_list: D015415:Biomarkers; D016207:Cytokines