Erectile dysfunction as a predictor of two-year prognosis in acute myocardial infarction.
BACKGROUND
Erectile dysfunction (ED) is a predictor or marker of coronary artery disease in patients at high risk of cardiovascular diseases. The aim of this study was to investigate the prevalence of ED in patients with acute myocardial infarction (AMI) and after 2 years of follow-up, and to determine the association between ED and the concentrations of the markers of inflammation, endothelial dysfunction and oxidative stress which were measured on the third day after hospital admission.


METHODS
The study included 80 patients aged 62.25 ± 10.47 years. The primary endpoints of interest were re-hospitalization due to cardiovascular causes and death during the 2 year period after hospital-ization. The Sexual Health Inventory for Men (SHIM) was assessed at the point of hospital discharge and 24 months thereafter.


RESULTS
40.1% of patients had some degree of ED. The percentage of patients without ED increased (13.2%), while the percentage of patients with severe ED significantly decreased (14.7%) after 2 years. Patients with ED had significantly higher B-type natriuretic peptide (BNP) levels and decreased levels of nitric-oxide. During the 2 years of follow-up, 9 patients died (6.5% without ED, 68.6% with ED) (c2 = 7.19, p = 0.015). During the same time period, 22 (27.5%) patients were re-hospitalized due to cardiovascular causes, of whom 59.1% had ED at hospital admission (p < 0.05).


CONCLUSIONS
Low levels of nitric-oxide were the best predictors of ED during AMI and after 2 years. ED predicted the worst outcomes of AMI: death and re-hospitalization. Lifestyle changes and nitric- -oxide donors could assist in the treatment of ED and in the improvement of long-term prognosis for AMI. (Cardiol J 2017; 24, 4: 393-402).
Svetlana
S
Apostolovic
Clinic for cardiovascular diseases, Clinical Center Nis, Serbia. draganastanojevic1@gmail.com.
Dragana
D
Stanojevic
Ruzica
R
Jankovic-Tomasevic
Sonja
S
Salinger-Martinovic
Tomislav
T
Kostic
Zoran
Z
Perisic
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D000072658:Non-ST Elevated Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D018384:Oxidative Stress; D010359:Patient Readmission; D010410:Penile Erection; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D055771:Serbia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D019332:Endothelin-1; D018836:Inflammation Mediators; D009569:Nitric Oxide
acute myocardial infarction; biomarker; endothelin-1; erectile dysfunction; nitric-oxide; oxidative stress; prognosis