The correlation between erectile dysfunction and the severity of coronary artery involvement in patients with coronary artery disease

Purpose: Erectile dysfunction (ED) may be considered as a clinical manifestation of generalized vascular disease. This study aimed to assess the correlation between ED and the severity of the involved coronary artery in patients with coronary artery disease (CAD). Materials and Methods: 255 men with CAD, who underwent coronary angiography (CAG), were evaluated for erectile function using a questionnaire that included a 5-item Version the International Index of Erectile Function (IIEF-5). Cardiovascular risk factors were also reviewed. The correlation between erectile function and the number of involved coronary vessels, age and number of accompanying cardiovascular risk factors were analyzed. Results: Of the patients, 59.6% had various degrees of ED, which were subdivided into mild (21.7%), moderate (14.5%) and complete (63.8%) according to the severity. The cardiovascular risk factors were hypertension, smoking, overweight, age, lipid abnormalities and diabetes in 67.8, 67.5, 47.1, 38.4, 28.6 and 19.6%, respectively. One, two and three coronary vessels were involved in 26.3, 27.4 and 21.2%, respectively, while 25.1% showed non specific finding on CAG, despite abnormal findings in the resting ECG and treadmill exercise test. Erectile function decreased significantly according to the increasing number of involved coronary vessels (p < 0.05), age (p < 0.001) and accompanying cardiovascular risk factors (p < 0.05). Of the cardiovascular risk factors, age, smoking and diabetes had negative effects on erectile function (p < 0.05) in patients with CAD. Conclusions: Statistically significant correlations were demonstrated between ED and the number of involved coronary vessels, age and the number of accompanying cardiovascular risk factors in patients with CAD. Furthermore, in patients with symptoms of chest discomfort, although CAG showed non specific findings, the possibility of hidden ED will need to be investigated.