BACKGROUND: Erectile dysfunction is highly prevalent in patients with the diseases of cardiovascular system, including patients with atrial fibrillation (AF).
Reasons for this high co-prevalence include endothelial dysfunction, inflammation, oxidative and emotional stress associated with AF. Association of AF-induced prothrombotic state and possible microthrombi in penile arteries with erectile dysfunctions remains unclear. Present study aims to assess if probability of AF-associated risk of peripheral cardioembolism may be associated with erectile dysfunction in AF patients.
METHODS: Probability of cardioembolic complications was assessed with two commonly used risk scores CHADS₂ and CHA₂DS₂-VASc in a group of continuous AF patients. All patients were also asked to fill an IIEF-5 questionnaire designed for screening for erectile dysfunction.
RESULTS: Mean CHADS₂ score in the whole study group was 1.1 ± 1.0 pts and CHA₂DS₂-VASc was 1.5 ± 1.4 pts. Erectile dysfunction was present in 57.4% of the 129-person study population. In patients with erectile dysfunction both CHADS₂ (0.9±1.0 vs. 1.3±1.1; p=0.03) and CHA₂DS₂-VASc (1.2±1.1 vs. 1.8±1.5; p=0.03) scores were significantly higher than in the group without dysfunction. After dividing patients according to age to a group younger than 65 years vs. ≥ 65 years, observed correlation was no longer significant in the younger group (p>0.05). In patients ≥65 years, in whom the risk scores are routinely used, dysfunction both CHADS₂ (1.1±0.9 vs. 2.0±0.9; p=0.02) and CHA₂DS₂-VASc (2.3±1.1 vs. 3.4±1.3; p=0.04) scores were higher in the group with erectile dysfunction.
CONCLUSIONS: Erectile dysfunctions in AF patients are associated with elevated cardioembolic risk. We postulate the diagnosis of erectile dysfunction could be considered as additional marker of prothrombotic state, and may be useful in clinical decision-making, especially useful in patients ≥65 years old.
Written by:
Szymański FM, Filipiak KJ, Płatek AE, Kotkowski M, Opolski G. Are you the author?
1st Department of Cardiology Medical University of Warsaw 1a Banacha Street 02-097 Warsaw, Poland.
Reference: Cardiol J. 2015 Mar 3. Epub ahead of print.
doi: 10.5603/CJ.a2015.0010
PubMed Abstract
PMID: 25733318