It is low among men who have acute coronary syndrome (ACS), mainly acute myocardial infarction with one blood vessel affected for example, who have had a sudden heart attack without a background of furred-up arteries but high in those with chronic coronary syndrome (CCS), mainly effort-induced angina pectoris and involving many arteries narrowed by atherosclerosis.
They have also shown in their study of nearly 300 men, that among CCS patients who had both ED and CAD, 93% reported symptoms of erectile dysfunction (ED) between one and three years before experiencing angina, with two years being the average time.
Their findings are reported on line (Wednesday 19 July) in European Heart Journal[1], journal of the European Society of Cardiology.
The results have prompted the researchers, from the University of Milan and the University Vita-Salute Ospedale S. Raffaele, also in Milan, to call for long-term medical surveillance in patients with ED and multiple risk factors, but with no clinical signs of coronary artery disease. They say their research has fuelled the concept of erectile dysfunction as 'sentinel of the heart'.
Their warning has been reinforced in an accompanying editorial[2] by Dr Graham Jackson, consultant cardiologist at the Cardiothoracic Centre at Guy's and St Thomas' NHS Foundation Trust in London, UK.
"All men with ED and no cardiac symptoms need a detailed cardiac assessment, blood pressure measurement, fasting lipid profile and glucose, as well as lifestyle advice regarding weight and exercise," said Dr Jackson. "Those at cardiovascular risk ideally need stress testing and referral for risk reduction therapy, and advice with appropriate follow-up."
Lead author of the study Dr Piero Mon
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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-153-677-2181
European Society of Cardiology
18-Jul-2006