(053) ASSOCIATIONS BETWEEN CORONARY ARTERY CALCIUM SCORES AND ERECTILE DYSFUNCTION PRESENT: INITIAL RESULTS FROM MONTAGE DATA POOL
Authors: Furtado T , Rizzo A , Borrell J , Furtado MH , Gilyard S , Andino J 
Published: December 2024

Abstract

Introduction
Erectile dysfunction (ED) is a multifactorial condition impacting adult men and is associated with an increased risk of cardiovascular disease (CVD). Existing studies have identified shared risk factors among ED and CVD including hypertension, diabetes, dyslipidemia, obesity, aging, and smoking. Furthermore, literature suggests a bidirectional predictive relationship between CVD and ED, even when controlling for confounding factors. In accordance with the updated Princeton IV guidelines, which recommend coronary artery calcium (CAC) score testing in low-risk men with vasculogenic ED, our study sought to investigate the link between CAC scores and the prevalence of ED within historical cohorts.

Objective
This study aims to evaluate the association between CAC scores and ED diagnosis and treatment.

Methods
Using Montage software, data were collected from 108 men who underwent CAC score evaluation at a tertiary referral center between January to March 2019. Retrospective chart reviews were conducted to identify patients with ED pre- and post CAC score. Based on validated cut-offs for CVD risk, patients were divided into three groups for analysis: low-risk (CAC score 0), moderate-risk (CAC score 1-100) and high-risk (CAC score &gt; 100). Multivariate logistic regression was performed using JMP17.

Results
Of the 108 patients, 103 had complete data available for evaluation (mean age (±SD): 54 years (±11)). 71% were White, 4% were Asian, 3% were African American and only 4% were Hispanic or Latino. Across the three CAC score groups, 45 patients (44%) were low-risk, 32 (31%) moderate-risk, and 26 (25%) high-risk. Mean age (±SD) was 47 (±10), 55 (±8), and 63 (±8) years, respectively. The prevalence of ED was 18% in low-risk, 28% in moderate-risk, and 58% in high-risk groups. 32 patients had ED – 69% had ED prior to CAC testing and remainder developing after CAC, with a median time lapse of 981 days (SD ± 507) between CAC and diagnosis. Factors such as CAD, HTN, and alcohol use were more prevalent in patients with ED (p = 0.023, p = 0.009, and p = 0.044, respectively), while smoking, BMI, and diabetes did not show significant differences. On univariate analysis, the likelihood of ED was found to be significantly higher in men with high-risk CAC scores (OR = 6.31, p = 0.001). However, on multivariate analysis, the effect of high-risk CAC score on likelihood of ED was not significant (OR 2.82, p = 0.123) while age remained a significant predictor (OR 1.06, p = 0.048).

Conclusions
In a predominantly white patient cohort, CAC score &gt; 100 was strongly correlated with ED; however, on multi-variate analysis much of this associated was explained by the older age of the high-risk cohort. Given the small sample size of this preliminary analysis, future efforts are ongoing to access and study a larger historical cohort. Deepening our understanding of the relationship between CAC and ED could enhance cardiovascular risk management and has the potential to improve efforts to help men engage in preventative care.

Disclosure
No.