Efficacy and limits of sildenafil citrate in patients with arterial erectile dysfunction: role of peripheral arterial disease and cardiovascular comorbidities.
- Author:
Enzo VICARI
1
;
Mariano MALAGUARNERA
;
Sandro La VIGNERA
;
Fabio CALZAVARA
;
Carmelo BATTIATO
;
Aldo E CALOGERO
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Arterial Occlusive Diseases; complications; drug therapy; physiopathology; Atherosclerosis; complications; Cardiovascular Diseases; complications; drug therapy; Erectile Dysfunction; drug therapy; etiology; physiopathology; Humans; Lower Extremity; blood supply; Male; Middle Aged; Physical Examination; Piperazines; therapeutic use; Purines; therapeutic use; Regional Blood Flow; physiology; Retrospective Studies; Risk Factors; Sildenafil Citrate; Sulfones; therapeutic use; Treatment Outcome; Vasodilator Agents; therapeutic use
- From: Asian Journal of Andrology 2008;10(6):847-853
- CountryChina
- Language:English
-
Abstract:
AIMTo evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction (ED) was related to their peak systolic velocity (PSV), peripheral atherosclerosis, cardiovascular risk factors (RF) and/or comorbidities at low cardiovascular risk.
METHODSWe enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial ED alone (group A, n = 27), ED plus atherosclerotic carotid artery (group B, n = 23), ED plus lower limb artery abnormalities (group C, n = 25), and ED plus carotid and lower limb artery abnormalities (group D, n = 22). Sildenafil efficacy (100 mg twice a week for 12 weeks) was also examined in patients with =or>3 RF, peripheral atherosclerosis and no cardiovascular comorbidities (group E, n = 20).
RESULTSMedian PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients (77.8%), intermediate in groups B and C (65.2% and 56%) and lowest in groups D (45.4%) and E (50%), and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was negatively influenced by: =or>3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidities was positively related to atherosclerosis localization or extension (25, 35, 38 and 47 in groups A, B, C and D, respectively).
CONCLUSIONLow sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.
