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


Submitted: August 22, 2017
Accepted: October 23, 2017
Published: December 31, 2017
Abstract Views: 1913
PDF: 1243
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Authors

  • Rosanna Iacona Chair and Division of Cardiology, University Hospital “Paolo Giaccone”, Palermo, Italy.
  • 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.
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.

Iacona, R., Bonomo, V., Di Piazza, M., Sansone, A., Usala, M., Novo, S., & Pavone, C. (2017). Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone. Archivio Italiano Di Urologia E Andrologia, 89(4), 313–315. https://doi.org/10.4081/aiua.2017.4.313

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