(588) Erectile Dysfunction and Cardiovascular Risk in Dialysis Patients: A 5-Year Prospective Analysis

Introduction Based on the theory that progressive occlusive atherosclerotic disease may manifest earlier in smaller penile arteries than in larger coronary arteries, numerous studies have demonstrated the predictive ability of ED for future CVD events. The ED symptoms precede clinically overt CVD by 2–3 years, and more severe ED is associated with an increased risk of CVD. However, it remains unclear whether severe ED can predict future CVD events in men undergoing dialysis, who are generally recognized as at high-risk for accelerated atherosclerosis. Objective The aim of this study was to evaluate the impact of severe ED on the occurrence of future CVD events in men undergoing dialysis. Methods This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥ 8) and severe ED (SHIM score ≤ 7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated. Results The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 65% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; P = 0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; P = 0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; P = 0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (P = 0.110, P = 0.101, and P = 0.740, respectively). Conclusions ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis. Disclosure No