Simplified international index of erectile function (IIEF-5) and coronary artery disease in hypertensive patients

Abstract

Background: Erectile Dysfunction (ED) is associated with increased risk of coronary artery disease (CAD). Objective: To evaluate the association between ED, determined by the Simplified International Index of Erectile Function (IIEF-5) and CAD. Methods: This was a cross-sectional cohort study that evaluated 263 hypertensive patients (55 [50-61] years). ED was assessed through the IIEF-5 and CAD by the history of previous myocardial revascularization and/or coronary angiography. Results: The IIEF-5 correlated with creatinine clearance [CrCl] (Rho = 0.23, p <0.001) and age (Rho = -0.22, p <0.001). Forty-two patients had CAD, and IIEF-5 was able to discriminate them (area under the ROC curve = 0.63, p = 0.006). Patients were divided into two groups: IIEF-5 ≤ 20 (n = 140) and IIEF-5 > 20 (n = 123); those with lower IIEF-5 scores were older (57 [52-61] vs. 54 [45-60] years, p = 0.002), had higher prevalence of CAD (22% vs. 9%, p = 0.004), smoking (64% vs. 47%, p = 0.009) and use of calcium channel inhibitors (65% vs. 43.%, p = 0.001), as well as lower CrCl (67.3 [30.8 to 88.6] vs. 82.6 [65.9 - 98.2] ml/min, p <0.001). The IIEF-5 ≤ 20 was associated with increased risk of CAD in the logistic regression, both univariate (OR = 2.89 [95%CI: 1.39 - 6.05]), and after adjusting for age, diabetes, CrCl, smoking, mean arterial pressure and use of antihypertensive drugs (OR = 2.59 [95% CI: 1.01 - 6.61]). Conclusion: The IIEF-5 is associated with the diagnosis of CAD and its use can add information to cardiovascular risk stratification in hypertensive patients.