Department of Surgery, Division of Urology, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan.
J Sex Med. 2011 Jan;8(1):240-6. doi: 10.1111/j.1743-6109.2010.01973.x. Epub 2010 Aug 16.
Previous cross-sectional studies have suggested that erectile dysfunction (ED) represents an independent risk factor for future cardiovascular events. However, very few studies have attempted to examine the association between ED and subsequent stroke.
The aim of this study is to estimate the risk of stroke during a 5-year follow-up period after the first ambulatory care visit for the treatment of ED using nationwide, population-based data and a retrospective case-control cohort design in Taiwan.
This study used data sourced from the "Longitudinal Health Insurance Database." The study cohort comprised 1,501 patients who received a principal diagnosis of ED between 1997 and 2001 and 7,505 randomly selected subjects as the comparison cohort. Each patient (N = 9,006) was then individually tracked for 5 years from their index ambulatory care visit to identify those who had diagnosed episodes of stroke.
Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-year stroke-free survival rate for the two cohorts.
Of the sampled patients, 918 (10.2%) developed stroke within the 5-year follow-up period, that is, 188 individuals (12.5% of the patients with ED) from the study cohort and 730 individuals (9.7% of patients in the comparison cohort) from the comparison cohort. The log-rank test indicated that patients with ED had significantly lower 5-year stroke-free survival rates than those in the comparison cohort (P < 0.001). After adjusting for the patient's monthly income, geographical location, hypertension, diabetes, coronary heart disease, peripheral vascular disease, atrial fibrillation, and hyperlipidemia, patients with ED were more likely to have a stroke during the 5-year follow-up period than patients in the comparison cohort (hazard ratio = 1.29, 95% confidence interval = 1.08 - 1.54, P < 0.01).
These results suggest that ED is a surrogate marker for future stroke in men.
先前的横断面研究表明，勃起功能障碍（ED）是未来心血管事件的独立危险因素。然而，很少有研究试图检查 ED 与随后的中风之间的关联。
本研究旨在使用全国性的基于人群的数据和回顾性病例对照队列设计，在台湾，从第一次接受 ED 治疗的门诊就诊后 5 年的随访期间，估计中风的风险。
本研究使用了来自“纵向健康保险数据库”的数据。研究队列包括 1501 名在 1997 年至 2001 年期间接受 ED 主要诊断的患者和 7505 名随机选择的作为对照组的患者。然后，每位患者（N=9006）从其指数门诊就诊开始被单独跟踪 5 年，以确定那些患有中风诊断的患者。
进行分层 Cox 比例风险回归分析，以比较两个队列的 5 年无中风生存率。
在抽样患者中，918 名（10.2%）在 5 年随访期间发生中风，即研究队列中有 188 名（ED 患者的 12.5%）患者和对照组中有 730 名（对照组患者的 9.7%）患者。对数秩检验表明，ED 患者的 5 年无中风生存率明显低于对照组（P <0.001）。在调整了患者的月收入、地理位置、高血压、糖尿病、冠心病、外周血管疾病、心房颤动和高脂血症后，ED 患者在 5 年随访期间发生中风的可能性高于对照组患者（风险比=1.29，95%置信区间=1.08-1.54，P<0.01）。
这些结果表明，ED 是男性未来中风的替代标志物。
