Erectile dysfunction (ED) can improve the effectiveness of screening diabetic men for asymptomatic coronary artery disease (CAD), according to researchers.
About 40% of diabetic patients with asymptomatic CAD are missed on the basis of the current screening guidelines, they noted.
Carmine Gazzaruso, MD, of the Department of Internal Medicine, I.R.C.C.S. Policlinico San Donato, San Donato, Milan, Italy, and colleagues studied 293 men with newly diagnosed type 2 diabetes. Subjects had a mean age of 56.6 years. Of these, 219 did not have myocardial ischemia (NO CAD group) and 74 had a coronary stenosis documented angiographically (CAD group). The investigators assess five risk factors of current screening guidelines (hypertension, dyslipidemia, family history of CAD, smoking, micro- or macroalbuminuria) as well as ED.
ED was significantly more common in the CAD than the NO CAD group (37.8% vs. 15.1%). It was a significant predictor of asymptomatic CAD, which was 4.4 times more likely to be present in men with ED than in those without ED.
If ED is added to the list of risk factors, the investigators reported in Endocrine (published online ahead of print), it can increase the sensitivity of current guidelines from 62% to 89%, without a significant change in specificity (from 60% to 57%). It can increase the negative predictive value from 82% to 94%. In addition, ED can reduce the proportion of patients with silent CAD missed at screening from 37.8% to 10.8%.