Prevalence of Erectile Dysfunction among Patients with Coronary Artery Disease

Abstract

Both coronary artery disease (CAD) and erectile dysfunction (ED) are widespread illnesses that frequently coexist. Numerous triggering risk factors and pathophysiological mechanisms contribute to both diseases. Penile color Doppler ultrasound can serve as a crucial tool to evaluate penile arterial blood flow. Therefore, this study aims to assess the ED prevalence in CAD patients, to determine the socioeconomic and clinical profiles of the population, and to define risk factors of their development. The cross-sectional study included 100 male patients who were admitted to the coronary angiography (CAG) unit. Patients were asked if they had ED, and if present, it was graded using the International Index of Erectile Function 5. Right and left cavernosal arteries were examined using color Doppler and erection hardness to assess the peak systolic velocity (PSV) and end-diastolic velocity. Among the 52 cases that suffered from ED, most of the cases had mild grades (38.5%). All cases without ED (100%) had penile artery Doppler PSV findings ≥30 (cm/s) with an average Doppler PSV of 48.02 ± 7.49 cm/s for the right cavernosal arteries and 47.4 ± 7.17 cm/s for the left cavernosal arteries. Yet, 71.2% of cases with ED had penile artery Doppler PSV findings <30 (cm/s) with an average Doppler PSV of 29.1 ± 7.57 cm/s for the right cavernosal arteries and 28.69 ± 7.11 cm/s for the left cavernosal arteries. Furthermore, by CAG, 50% of cases without ED had blockage not necessitating a coronary intervention (no significant disease) compared to 25% of cases with ED. There was positive correlation between advanced grade of ED and age (r = 0.327, P  < 0.001), hypertension (r = 0.213, P = 0.033), DM (r = 0.253, P = 0.011), smoking (r = 0.202, P = 0.044), and severity of CAD (r = 0.332, P  < 0.001). Patients with multivessel CAD have a significantly higher incidence and more severity of ED. Moreover, pathological penile vessels PSV (<25 or <30 cm/s) via Doppler ultrasound is mostly valuable as a noninvasive tool to define ED attributable to vascular impairment that may be antecedent to atherosclerosis in the coronary vessels.