Abstract 2782: Erectile Dysfunction Predicts High Risk Findings on Myocardial Perfusion SPECT Imaging in Men without Prior Heart Disease
Background: Erectile dysfunction (ED) has recently been associated with a future risk of myocardial infarction (MI) in men without prior coronary artery disease (CAD), yet the benefit of stress testing in men with ED and without prior CAD is unknown. Stress myocardial perfusion SPECT imaging (MPI) allows detection of CAD and predicts cardiovascular (CV) prognosis. Our goal was to determine the association between ED and findings on stress MPI testing which predict CV prognosis, in men without prior CAD.
Methods: As part of a prospective data collection, 411 men referred for stress MPI were prospectively screened for ED with the validated international index of erectile function (IIEF). Men with prior CAD or MI were excluded. CV risk factors and medications were recorded. ED was defined as an IIEF score of ≤25. CAD was defined as mild [summed stress score (SSS) ≥4] or severe (SSS>8).
Results: ED was present in 45% of pts. ED pts were older, had more diabetes, hypertension and current tobacco use. ED was found to be associated with more mild and severe CAD on stress MPI, and with more composite high risk (HR) stress MPI findings (SSS>8, LVEF<40%, transient ischemic dilation [TID]) (Table 1⇓). Among pts referred for exercise, ED was associated with lower exercise time and Duke Treadmill score (DTS) (Table 1⇓). Multivariate analysis considering CV risk factors and medication use found ED to be an independent predictor of severe CAD (OR 2.1, 95% CI 1.2–3.7, p=0.01), and the composite of any HR MPI findings (2.4 95% CI 1.4 – 4.1, p < 0.01).
Conclusions: Among men without prior CAD referred for stress MPI testing, ED is associated with adverse prognostic indicators including lower exercise time, lower DTS, more mild and severe CAD, and is an independent predictor of severe CAD and high risk MPI findings. Further study is needed to determine if men with ED would benefit from screening for CAD with MPI testing.