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Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone

Rosanna Iacona, Vito Bonomo, Mariaconcetta Di Piazza, Angela Sansone, Manuela Usala, Salvatore Novo, Carlo Pavone
  • Rosanna Iacona
    Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy | rosanna.iacona@virgilio.it
  • Vito Bonomo
    Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy
  • Mariaconcetta Di Piazza
    Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy
  • Angela Sansone
    Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy
  • Manuela Usala
    Orthopedic Institute Rizzoli, Department of Sicily Region (DRS), Bologna, Italy, Italy
  • Salvatore Novo
    Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy
  • Carlo Pavone
    Chair and Division of Urology, University Hospital “Paolo Giaccone”, Palermo, Italy

Abstract

Objective: Testosterone levels play a role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. Materials and methods: Our cohort included 802 adult subjects, from 40 to 80 years. Patients were excluded if they had a past history of peripheral or coronary artery disease, and revascularization. A blood sample was drawn to valuate testosterone level, and we considered normal testosterone levels 300 ng/dl. FMD (flow mediated dilatation) of the brachial artery was assessed by measuring the increase of the brachial artery diameter during reactive hyperemia after transient forearm ischemia. B-mode longitudinal images of the brachial artery were obtained at the level of the antecubital fossa. The FMD was defined as the percentage change in the brachial artery diameter 60 s after releasing the ischemic cuff. Erectile dysfunction (ERD) was assessed by the International Index of Erectile Function-5 (IIEF-5) score questionnaire. We considered composite end points including the following major adverse cardiovascular events (MACEs) Results: Subjects with lower serum testosterone levels (n = 332) had higher prevalence of traditional cardiovascular risk factors, such as hypertension (p = 0.009), diabetes (p = 0.03), dyslipidemia (p < 0.0001), obesity (p = 0.002), and endothelial function score (p < 0.0001). AMI, death after AMI, major stroke and all clinical events were more frequent (p < 0.001) in patients with testosterone levels < 300 ng/dl. Further, by multiple logistic regression analysis we found that only dyslipidemia (p = 0,001), obesity (p = 0,007), testosterone < 300 ng/dl (p < 0,0001) and ED (p < 0,0001) were independent predictors of future events. Conclusions: A therapeutic intervention on testosterone may not only have a positive effect on the cardiovascular system but also an important role in preventing new cardiovascular events.

Keywords

Erectile dysfunction; Cardiovascular events; Prevention

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Submitted: 2017-08-22 14:38:54
Published: 2017-12-31 00:00:00
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Copyright (c) 2018 Rosanna Iacona, Vito Bonomo, Mariaconcetta Di Piazza, Angela Sansone, Manuela Usala, Salvatore Novo, Carlo Pavone

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