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01-10-2011 | Original Article

Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes

Authors: Carmine Gazzaruso, Adriana Coppola, Tiziana Montalcini, Cinzia Valenti, Adriana Garzaniti, Gabriele Pelissero, Fabrizio Salvucci, Pietro Gallotti, Arturo Pujia, Colomba Falcone, Sebastiano B. Solerte, Andrea Giustina

Published in: Endocrine | Issue 2/2011

Abstract

About 40% of diabetic patients with asymptomatic coronary artery disease (CAD) are missed on the basis of the current screening guidelines. Erectile Dysfunction (ED) is a powerful marker of asymptomatic CAD. Aim of the study is to evaluate whether ED can improve the effectiveness of the current guidelines for the screening of CAD in diabetes. From among 299 consecutive men with newly diagnosed type 2 diabetes without any apparent vascular complication, 293 (mean age 56.6 ± 5.9 years) were enrolled. Among them, 219 did not have myocardial ischemia (NO CAD group) and 74 men had a coronary stenosis angiographically proven (CAD group). Five risk factors (RFs) of the current screening guidelines (hypertension, dyslipidemia, family history for CAD, smoking e micro/macroalbuminuria) and ED were assessed. ED was significantly more prevalent in the CAD than in the NO CAD group (37.8 versus 15.1%; P < 0.001) and was a predictor of asymptomatic CAD (OR: 4.4; 95%CI: 2.1–9.0; P < 0.001). If ED is added to the list of RFs, it can increase the sensitivity of the current guidelines from 62 to 89%, without a significant variation in specificity (from 60 to 57%). The negative predictive value can increase from 82 to 94%. ED can reduce from 37.84 to 10.81% the percentage of patients with silent CAD missed at the screening. This study first shows that ED can improve the effectiveness in discriminating diabetic men to screen for asymptomatic CAD, when it is added to the list of RFs of the current screening guidelines.

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Title: Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes
Authors: Carmine Gazzaruso
Adriana Coppola
Tiziana Montalcini
Cinzia Valenti
Adriana Garzaniti
Gabriele Pelissero
Fabrizio Salvucci
Pietro Gallotti
Arturo Pujia
Colomba Falcone
Sebastiano B. Solerte
Andrea Giustina
Publication date: 01-10-2011
Publisher: Springer US
Published in: Endocrine / Issue 2/2011
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-011-9523-9

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