Fujita Naoki, Momota Masaki, Ozaki Yusuke, Tobisawa Yuki, Yoneyama Tohru, Okamoto Teppei, Yamamoto Hayato, Hatakeyama Shingo, Yoneyama Takahiro, Hashimoto Yasuhiro, Yoshikawa Kazuaki, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Glycotechnology, Center for Advanced Medical Research, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
World J Mens Health. 2023 Oct;41(4):900-908. doi: 10.5534/wjmh.220179. Epub 2023 Jan 19.
To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis.
This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated.
The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533-6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687-6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358-1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively).
ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.
评估重度勃起功能障碍（ED）对透析男性未来主要不良心血管事件（MACE）的影响。
这项前瞻性队列研究纳入了71名透析男性。使用男性性健康量表（SHIM）评估ED。男性被分为轻度/中度ED组（SHIM评分≥8）和重度ED组（SHIM评分≤7）。主要终点是无MACE生存。MACE是心肌梗死、心血管死亡和中风的综合指标。次要终点是无心脏事件生存和总生存（OS）。此外，评估了重度ED对5年MACE、5年心脏事件和5年总死亡率的预测能力。
纳入男性的中位年龄和随访时间分别为64岁和58个月。SHIM评分中位数为4.0；所有患者均有一定程度的ED，64.7%患有重度ED。在背景校正的多变量分析中，重度ED与无MACE生存时间缩短（风险比[HR]，1.890；95%置信区间[CI]，0.533 - 6.706；p = 0.324）、无心脏事件生存时间缩短（HR，2.081；95% CI，0.687 - 6.304；p = 0.195）和OS缩短（HR，0.817；95% CI，0.358 - 1.863；p = 0.630）均无显著相关性。重度ED对5年MACE、5年心脏事件和5年总死亡率的预测能力无显著提高（p分别为0.110、0.101和0.740）。
ED严重程度与无MACE生存时间缩短、无心脏事件生存时间缩短或OS缩短均无关联，且ED严重程度不能提高透析男性这些结局的预测能力。
