Sai Ravi Shanker A, Phanikrishna B, Bhaktha Vatsala Reddy C
Cardiologist, Department of Cardiology, Narayana Medical College, Chinta Reddy Palem, Nellore 524003, Andhra Pradesh, India.
Indian Heart J. 2013 Mar-Apr;65(2):180-6. doi: 10.1016/j.ihj.2013.02.013. Epub 2013 Feb 24.
BACKGROUND/AIMS: To investigate the prevalence of erectile dysfunction (ED) in patients with coronary artery disease (CAD), its relationship between the severity of ED and the extent of coronary vessel involvement and to register the mean time interval between them.
240 patients with CAD divided into three age-matched groups: Group 1 (n = 60), ACS with one-vessel disease (1VD); group 2 (n = 60), ACS with 2,3VD; group 3 (n = 60), CSA. Control group (C, n = 60) was composed of patients with suspected CAD who were found to have entirely normal coronary arteries by angiography. ED as any value <26 according to the Gensini's scores and according to the International Index of Erectile Function (IIEF).
ED prevalence was 76%. ED prevalence was lower in G1 vs. G3 (22 vs.65%). G2 ED rate [55%, P < 0.0001] IIEF = 24 (17-29) & Gensini's scores-21 (12.5-32) were significantly different from G1 and similar to G3, ED in ACS differs according to the extent of CAD. G3 patients who had ED symptoms prior to CAD symptoms and time interval between ED and CAD symptom onset in CCS according to number of vessels. Onset of sexual dysfunction occurred before CAD onset with a mean time interval of 24 m [12-36].
Early diagnosis of ED, cardiovascular assessment and aggressive treatment of cardiovascular risk factors might have contributed to prevent the acute events of this patient. Patients should be systematically screened for ED as a part of periodic examination programs. This would lead to early detection of modifiable vascular risk factors, or already existing vascular disease and to prevent ED and vascular disease progression through pharmacological and life style modifications.
背景/目的：研究冠心病（CAD）患者勃起功能障碍（ED）的患病率、ED严重程度与冠状动脉受累程度之间的关系，并记录两者之间的平均时间间隔。
240例CAD患者分为三个年龄匹配组：第1组（n = 60），单支血管病变（1VD）的急性冠状动脉综合征（ACS）；第2组（n = 60），2、3支血管病变的ACS；第3组（n = 60），慢性稳定型心绞痛（CSA）。对照组（C，n = 60）由疑似CAD但血管造影显示冠状动脉完全正常的患者组成。根据Gensini评分和国际勃起功能指数（IIEF），ED定义为任何小于26的值。
ED患病率为76%。第1组的ED患病率低于第3组（22%对65%）。第2组的ED发生率[55%，P < 0.0001]，IIEF = 24（17 - 29），Gensini评分为21（12.5 - 32），与第1组有显著差异且与第3组相似，ACS中的ED根据CAD的程度而不同。第3组中在CAD症状出现之前有ED症状的患者以及根据血管数量在慢性冠状动脉综合征（CCS）中ED与CAD症状发作之间的时间间隔。性功能障碍发作发生在CAD发作之前，平均时间间隔为24个月[12 - 36]。
ED的早期诊断、心血管评估以及对心血管危险因素的积极治疗可能有助于预防该患者的急性事件。应将ED系统筛查作为定期检查项目的一部分。这将有助于早期发现可改变的血管危险因素或已存在的血管疾病，并通过药物治疗和生活方式改变来预防ED和血管疾病进展。
