Author + information
- Daniel Peter Andersson,
- Ylva Trolle Lagerros,
- Alessandra Grotta,
- Rino Bellocco,
- Mikael Lehtihet and
- Martin Holzmann
Background: Erectile dysfunction (ED) is associated with an increased risk of cardiovascular disease in healthy men. However, the association between ED and death or cardiovascular outcomes after a first MI is unknown.
Methods: In a Swedish nation-wide cohort study all men < 80 years of age hospitalized for MI during 2007 through 2013 without prior MI, cardiac revascularization, or ED were included. Erectile dysfunction, defined as dispensed ED medication, either phosphodiesterase-5 inhibitors or alprostadil, was related to risk of death, MI, cardiac revascularization or heart failure.
Results: 43 145 men were included, of whom 7.1% developed ED during a mean 6.2 years (141 739 person-years) of follow up. Men with, compared to those without ED, had a 30% lower mortality [adjusted hazard ratio (HR), 0.70 (95% CI, 0.580.85)], and 36% lower risk of hospitalization for heart failure [HR, 0.64 (95% CI, 0.47-0.88)]. Men with, compared to those without phosphodiesterase-5 inhibitor treatment, had a reduced risk of death [HR, 0.60 (95% CI, 0.49-0.74)]. There was no association between mortality and treatment with alprostadil. The adjusted risk of death in men with 1, 2-5, and >5 dispensed prescriptions of phosphodiesterase-5 inhibitors was reduced by 27% (HR, 0.73 (95% CI, 0.42-1.28), 45% (HR, 0.55 (95% CI, 0.30-1.01), and 79% (HR, 0.21 (95% CI, 0.09-0.49), respectively, when compared to alprostadil treatment.
Conclusions: Incident ED after a first MI was associated with a reduced mortality and heart failure hospitalization. Only men treated with phosphodiesterase-5 inhibitors had a reduced risk, which appeared to be dose-dependent.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-344
- 2017 American College of Cardiology Foundation