Erectile dysfunction as a predictor of asymptomatic coronary artery disease in elderly men with type 2 diabetes

Objectives. Erectile dysfunction (ED) is a recognized predictor of asymptomatic coronary artery disease (CAD) in diabetic patients and represents the most common sexual dysfunction in older men with or without diabetes. No study has evaluated whether ED is able to predict the presence of asymptomatic CAD in elderly diabetic patients. Therefore, the aim of the present study is to evaluate whether ED is associated with asymptomatic CAD in 66 years or older men with type 2 diabetes. Methods. We consecutively enrolled 328 men with type 2 diabetes: 213 subjects were 65 years old or younger (GROUP A) and 115 were older than 65 years (GROUP B). After a systematic screening for asymptomatic CAD, the two study groups were stratified by the presence/absence of documented angiographic CAD. Forty-five subjects in the GROUP A and 37 in the GROUP B had CAD. ED has been evaluated by the validated International Index of Erectile Function-5 (IIEF-5) questionnaire. Results. In the GROUP A the prevalence of subjects with ED was significantly higher among subjects with than in those without CAD (31.1% vs 16.6%; p=0.030), while no significant difference in ED prevalence was observed between patients with and without CAD among older men (48.6% vs 39.7%; p=0.364). The multivariate analysis found that ED was significantly associated with asymptomatic CAD in younger (OR: 1.87; 95%CI:1.02-7.31; p=0.046), but not in older men. Conclusions. Our study shows that ED seems to lose its powerful role of predictor of asymptomatic CAD in elderly type 2 diabetic patients.