| Summary: | Purpose: Erectile dysfunction (ED) confers an independent risk for cardiovascular events and total mortality. Central pressures and wave reflection indices independently predict cardiovascular events. Aim of this study is to investigate whether central haemodynamics predict major adverse cardiovascular events (MACEs) in ED patients beyond traditional risk factors.
Methods: MACEs in relation to aortic pressures and Augmentation index (AIx) were analyzed with proportional hazards models in 398 patients (mean age, 56 years) without established cardiovascular disease (CVD).
Results: During the mean follow-up period of 6.5 years, a total of 29 (6.5%) MACEs occurred. The adjusted relative risk (RR) of MACEs was 1.062 (95% CI 1.016–1.117) for a 10-mmHg increase of aortic systolic pressure, 1.117 (95% CI 1.038–1.153) for a 10-mmHg increase of aortic pulse pressure (PP), and 1.191 (95% CI 1.056–1.372) for a 10% absolute increase of AIx. The based on categories for 10-year coronary heart disease risk and adapted at 6.5 years overall net reclassification index (NRI) showed marginal and indicative risk reclassification for AIx (15.7%, P=0.12) and aortic PP (7.2%, P=0.20) respectively.
Conclusions: Our results show for the first time that higher central pressures and wave reflections indices are associated with increased risk for a MACE in patients with ED without known cardiovascular disease. Considering the adverse prognostic role of central haemodynamics on outcomes, the present findings may explain part of the increased cardiovascular risk associated with ED.
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