How Can We Predict Asymptomatic Myocardial Ischemia in Patients with Vasculogenic Impotence?

Park, Jae Young; Kim, Soo Woong; Paick, Jae Seung

Abstract

PURPOSE
The majority of patients suffering from vasculogenic impotence are known to have at least one significant cardiovascular risk factor. This prospective study was conducted to define the potential predictors of asymptomatic myocardial ischemia in patients with vasculogenic impotence using a simple and practical method.
MATERIALS AND METHODS
After the baseline evaluations, patients with impotence of a presumed vascular origin, who were older than 45 years and with no history of myocardial ischemia, were enrolled in this study. According to the results of repeated pharmacological erection tests, the patients were divided into responders and non- responders. The cardiologic evaluations consisted of a comprehensive history taking an assessment of the cardiovascular risk factors, a physical examination and an exercise treadmill test.
RESULTS
A total of 97 patients completed this study. The number of patients having two or more cardiovascular risk factors was 15 of 46 (32.6%) in the responders and 25 of 51 (49.0%) in the non-responders, respectively (p=0.101). The ischemic ST- segment changes on the exercise treadmill test were only observed in 8 patients (15.7%) from the non-responders (p=0.006). All of these patients were older than 55 years and 7 of those had two or more cardiovascular risk factors including hypertension.
CONCLUSIONS
Based on the preliminary results, a cardiovascular evaluation may prove beneficial before prescribing sildenafil to vasculogenic impotence patients who are non-responders to pharmacological erection tests, are older than 55 years, and have 2 or more risk factors including hypertension.