P5345Association and prevalence of post-stroke erectile dysfunction with cardiovascular risk factors and co-morbidities
Authors: Trofenciuc M , Pop-Moldovan A , Onel M , Puticiu M , Tomescu M , Gaita D , Branea H , Bordejevic A , Mischie A , Hreniuc C 
Published: October 2019

Objectives

The aim of this study was to establish a correlation between prevalence and severity of erectile dysfunction (ED) and cardiovascular (CV) co-morbidities and ongoing medication and other risk factors associated with post-stroke ED.

Materials and methods

For 153 patients (57.04±6.54 years) with ischemic stroke, we evaluated the pre- and post-stroke prevalence of ED using the five-item International Index of Erectile Function questionnaire (IIEF5).

Erectile Function questionnaire (IIEF5). Within 5 days of admission we determined the stroke site location and severity using the National Institute of Health Stroke Scale (NIHSS). The pre- and post-stroke data obtained were compared with those of 30 control non-stroke patients (52.27±8.35). Additional cardiovascular co-morbidities, medication and risk factors were asset and analyzed.

Results

The IIEF5 scores were much lower [median 17 interquartile range (IQR) 10–20] post stroke than pre-stroke (median 22 IQR 12–23) and lower than in control group (median 22.5 IQR 21–24).

From the analysis of comorbidities and risk factors for stroke of post- stroke group and the control group, we infer that diabetes (p=0.003), hypercholesterolemia (p<0.001), and hypertension (p<0.001) were more common in patients with stroke than those in the control group. (Table 1).

From the statistical analysis of data on medication use by patients, results that more patients have used ACE inhibitors, calcium antagonists, beta blocking agents, diuretics, statins, oral agents, antiplatelet and oral anticoagulants after the stoke than before, and in terms of consumption of drugs before stroke compared with the control group, differences were not significant.

Lot 1 Lot 2 Lot 3 P values P values P values post-stoke patients pre-stroke patients control group [1 vs 3] [2 vs 3] [1 vs 2] No. of Patients 153 153 30 Age, mean ± SD 57.04±6.54 57.04±6.54 52.27±8.35 Pacient with ED, N (%) 127 (83%) 76 (49.67%) 9 (30%) <0.001 0.048 <0.001 Severity of ED, N (%)   Mild 74 (48.37%) 29 (18.95%) 7 (23.33%) 0.015 0.581 <0.001   Mild to moderate 1 (0.01%) 11 (7.19%) 1 (3.33%) 0.302* 0.694* 0.127*   Moderate 28 (18.30%) 21 (13.73%) 1 (3.33%) 0.052* 0.134* <0.001*   Severe 24 (15.69%) 15 (9.80%) 0 0.016* 0.136* <0.001* IIEF5 (Erectile function)   Mean ± SD 15.53±5.89 17.83±6.18 21.83±3.31 <0.001 <0.001 <0.001   Median (Q1–Q3) 17 (10–20) 22 (12–23) 22.5 (21–24) Hamilton Score   Normal 91 (59.4%) 144 (94.1%) 23 (76.6%)   Mild depression 40 (26.1%) 1 (0.6%) 5 (16.6%)   Moderate depression 11 (7.1%) 0 (0.0%) 1 (3.3%)   Severe depression 9 (5.8%) 6 (3.9%) 1 (3.3%)   Very severe depression 2 (1.3%) 2 (1.3%) 0 (0.0%) Comorbidities   Diabetes mellitus 59 (38.5%) 3 (10.0%) 0.003*   Hypercholesterolemia 104 (67.9%) 6 (20.0%) <0.001   Hypertension 121 (79.0%) 8 (26.6%) <0.001   Obesity 36 (23.5%) 6 (20.0%) 0.674   Smoking 53 (34.6%) 5 (16.6%) 0.056*   Atrial fibrillation 22 (14.3%) 2 (6.6%) 0.377*   Carotid artery stenosis 18 (11.7%) 1 (3.3%) 0.321*   Coronary hearth disease 26 (16.9%) 1 (3.3%) 0.086* Medication   ACE inhibitors 72 (47.0%) 32 (20.9%) 2 (6.6%) <0.001* 0.075* <0.001   Calcium Antagonists 49 (32.0%) 17 (11.1%) 4 (13.3%) 0.047* 0.755* <0.001   Beta-Blokers 65 (42.4%) 36 (23.5%) 3 (10.0%) 0.001* 0.142* <0.001   Diuretics 43 (28.1%) 14 (9.1%) 3 (10.0%) 0.039* >0.999* <0.001   Statins 99 (64.7%) 25 (16.3%) 4 (13.3%) <0.001* 0.791* <0.001   Oral antidiabetics 39 (25.4%) 25 (16.3%) 1 (10.0%) 0.007* 0.084* 0.442   Insulin 20 (13.0%) 15 (9.8%) 0 (0.0%) 0.048* 0.136* 0.369   Antiplatelet drugs 131 (85.6%) 14 (9.1%) 2 (6.6%) <0.001* >0.999* <0.001   Oral anticoagulants 22 (14.3%) 8 (5.2%) 0 (0.0%) 0.028* 0.357* 0.007   Antidepressants 28 (18.3%) 12 (7.84%) 2 (6.6%) 0.176* >0.999* 0.007

Conclusions

The prevalence and severity of ED increase after stroke due to disruption of autonomous central structures. The depression, functional impairment, CV co-morbidities and medication used after stroke may contribute to ED.