Prevalence of Asymptomatic Coronary Artery Stenosis Based on Coronary Computed Tomography Angiography in Adults with Erectile Dysfunction: A Cross-Sectional Study

Objectives: To investigate the prevalence of asymptomatic coronary artery stenosis (CAS) using coronary computed tomography angiography (CCTA) in Korean men with erectile dysfunction (ED). Subjects and Methods: A cross-sectional study was conducted on 108 men who underwent CCTA at a health promotion center in Pusan National University Yangsan Hospital. Each subject who was evaluated for ED using the International Index of Erectile Dysfunction (IIEF) questionnaire did not have a past history or symptoms of coronary artery disease (CAD). We assessed the association between ED and CCTA-based CAS. Results: The overall prevalence of ED was 57.4%; furthermore, age (p = 0.001) and fasting blood glucose (p =0.035) were the metabolic risk factors that were most significantly associated with the presence of ED. The overall frequency of CAS was 31.5%, and ED (p = 0.022), age (p < 0.001), fasting blood glucose (p = 0.021), and total cholesterol/high-density lipoprotein cholesterol (p = 0.029) were significantly associated with the presence of CAS. The prevalence of CAS was 40.3 and 19.6% in the ED and non-ED groups, respectively. Men with ED were 2.778 times more likely to present with CAS than those without ED (OR 2.778, 95% CI 1.143-6.749, p = 0.024); however multivariate logistic regression analysis, while controlling for age, total cholesterol/high-density lipoprotein cholesterol, and fasting blood glucose, suggested the absence of a significant association between ED and CCTA-based CAS. Conclusion: This study shows that CCTA-based CAS is a common phenomenon in men who have ED. Furthermore, ED patients without cardiac symptoms need to be investigated for the possibility of hidden CAD.