(809) Erectile Dysfunction and Penile Arterial Flow in Men with Coronary Artery Disease: A Cross-Sectional Doppler Ultrasound Study

Introduction Erectile dysfunction (ED) and coronary artery disease (CAD) share pathophysiological mechanisms derived from endothelial dysfunction and systemic atherosclerosis. Several studies have shown that ED may clinically precede CAD and reflect the degree of overall vascular damage. In Colombia, however, there is limited information regarding the relationship between penile Doppler ultrasound hemodynamic findings and the presence of coronary disease. This study aimed to provide local evidence on such correlation in men with a confirmed diagnosis of CAD Objective To determine the prevalence and severity of erectile dysfunction in men with coronary artery disease and to analyze its association with penile Doppler ultrasound hemodynamic findings and the main cardiovascular risk factors. Methods An observational cross-sectional study was conducted in 92 men with CAD confirmed by coronary angiography between 2021 and 2022. Erectile function was evaluated using the International Index of Erectile Function (IIEF-15, EF-domain). All patients underwent penile Doppler ultrasound with intracavernous alprostadil to measure peak systolic velocity (PSV). Coronary artery disease severity was estimated by the percentage of arterial obstruction as a continuous variable and by the number of affected vessels. Clinical variables (age, type 2 diabetes mellitus, dyslipidemia, hypertension, and body mass index) were analyzed. Non-parametric tests (Mann–Whitney, Kruskal–Wallis, and Spearman correlation) were applied To identify independent associations with ED severity, an (ordinal) regression model was applied, exploring interactions between age×PSV and T2DM×dyslipidemia. Significance was set at p<0.05. Results 92 men were included; mean age was 63 years (range 38–82); 74% had hypertension, 50% dyslipidemia, and 29% T2DM. 64% showed reduced penile arterial flow (<35 cm/s). The mean IIEF score was 17.9 ± 7.6, with moderate or severe dysfunction predominating (35%) . The prevalence of ED was 81.5%, mainly moderate and severe forms. In bivariate analyses, ED severity was significantly associated with older age (p<0.01), dyslipidemia (p=0.02), and reduced PSV (<35 cm/s; p=0.001). No significant correlation was found with BMI or hypertension. The percentage of coronary obstruction as a continuous variable (ρ≈–0.19; p≈0.07) and the number of affected arteries (p=0.31) showed no significant association with ED severity. In the multivariate model, age, dyslipidemia, and decreased PSV remained independently associated with greater ED severity. Although TIMI and GRACE scores did not reach statistical significance, patients with higher cardiovascular risk showed a clear trend toward more severe ED, reinforcing the link between coronary vascular damage and sexual function Conclusions Erectile dysfunction is highly prevalent in men with established coronary artery disease and is significantly associated with age, type 2 diabetes mellitus, dyslipidemia, and reduced penile arterial flow, with a higher prevalence than in the general population over 40 years of age. Although cardiovascular risk scores did not show statistical significance, which could be influenced by the sample size, the observed trend suggests that patients with greater coronary involvement tend to present more severe erectile dysfunction. These results support the importance of including sexual function assessment as an integral part of the clinical approach to cardiovascular patients, promoting a multidimensional care approach that combines prevention and treatment of vascular disease and male sexual health. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston medical Group