RESUMEN
ABSTRACT Objective To investigate the association between the severity of erectile dysfunction (ED) and coronary artery disease (CAD) in men undergoing coronary angiography for angina or acute myocardial infarct (AMI). Material and Methods We studied 132 males who underwent coronary angiography for first time between January and November 2010. ED severity was assessed by the international index of erectile function (IIEF-5) and CAD severity was assessed by the Syntax score. Patients with CAD (cases) and without CAD (controls) had their IIEF-5 compared. In the group with CAD, their IIEF-5 scores were compared to their Syntax score results. Results We identified 86 patients with and 46 without CAD. The IIEF-5 score of the group without CAD (22.6±0.8) was significantly higher than the group with CAD (12.5±0.5; p<0.0001). In patients without ED, the Syntax score average was 6.3±3.5, while those with moderate or severe ED had a mean Syntax score of 39.0±11.1. After adjustment, ED was independently associated to CAD, with an odds ratio of 40.6 (CI 95%, 14.3-115.3, p<0.0001). The accuracy of the logistic model to correctly identify presence or absence of CAD was 87%, with 92% sensitivity and 78% specificity. The average time that ED was present in patients with CAD was 38.8±2.3 months before coronary symptoms, about twice as high as patients without CAD (18.0±5.1 months). Conclusions ED severity is strongly and independently correlated with CAD complexity, as assessed by the Syntax score in patients undergoing coronariography for evaluation of new onset coronary symptoms.
Asunto(s)
Humanos , Masculino , Femenino , Índice de Severidad de la Enfermedad , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Angiografía Coronaria/métodos , Disfunción Eréctil/fisiopatología , Factores de Tiempo , Enfermedad de la Arteria Coronaria/complicaciones , Riesgo , Curva ROC , Análisis de Varianza , Estadísticas no Paramétricas , Angina Estable/complicaciones , Angina Estable/fisiopatología , Angina Estable/diagnóstico por imagen , Disfunción Eréctil/etiología , Angina Inestable/complicaciones , Angina Inestable/fisiopatología , Angina Inestable/diagnóstico por imagen , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/diagnóstico por imagenRESUMEN
A disfunção erétil tem fatores de risco similares aos das doenças cardiovasculares, mas também pode ser um fator de risco independente para tais doenças. As evidências atuais consideram a disfunção erétil como uma desordem primordialmente de origem vascular e, mais do que isso, como um marcador precoce das doenças cardiovasculares. Apesar disso, o potencial da disfunção erétil como um sinal para alertar os médicos para uma possível manifestação precoce de doenças cardiovasculares mais graves tem sido pouco explorado na prática clínica diária.