Prevalence and predictors of erectile dysfunction in coronary patients: efficacy of a post-infarction sexual education programme

Background Erectile dysfunction (ED) is a major comorbidity in patients with coronary artery disease (CAD), significantly impacting psychological well-being and quality of life after a cardiac event. Purpose To evaluate the prevalence of ED and identify its independent predictors in a coronary population, while assessing the efficacy of a dedicated sexuality education intervention. Methods A prospective randomized trial included 100 men with stable CAD. Sexual function was evaluated using the IIEF-5 score. The intervention group received a structured post-myocardial infarction (MI) sexuality education session, while the control group received standard care. Reassessment was performed after three months. Results The baseline prevalence of ED was 92%. Independent predictors of post-MI ED included advanced age (OR = 8.08; 95% CI: [1,114 – 58,662] ;p = 0.039), beta-blocker use (OR = 16.78; 95% CI: [1,655 – 170,217]; p = 0.017), and anxiety (OR = 46.90; 95% CI: [4,506-488,147]; p = 0.001). Three months post-intervention, the intervention group showed a significant decrease in ED rates (42% vs 94% at baseline; p < 0.001), outperforming the control group (90% vs 70%; p >0,5). The intervention yielded an overall improvement in sexual function with an OR of 4.53 (95% CI: [1.95-10.51]; p<0,001). Conclusions ED is highly prevalent in post-MI patients but remains significantly reversible through targeted education. Incorporating sexual health counseling into therapeutic education and cardiac rehabilitation is imperative to restore sexual function and alleviate associated anxiety.