Assessment of Erectile Dysfunction and Coronary Artery Disease Severity

Erectile dysfunction (ED) and coronary artery disease (CAD) share a common pathophysiological substrate predominantly driven by systemic endothelial dysfunction, vascular inflammation, and atherosclerosis. Under the "artery size hypothesis," atherosclerotic plaque accumulation leads to clinical symptoms earlier in smaller vessels than in larger ones. Because penile cavernosal arteries are smaller in diameter (1-2 mm) compared to the proximal left anterior descending coronary artery (3-4 mm), lumen obstruction typically manifests as erectile impairment before overt coronary symptoms surface.

Consequently, assessing erectile health provides a critical non-invasive window into systemic vascular disease and serves as an early clinical marker for cardiovascular risk stratification. The 2021 European Society of Cardiology (ESC) Guidelines on cardiovascular disease prevention explicitly mandate evaluating organic ED as an independent risk modifier for silent cardiovascular disease.

Inclusion criteria

1 - Male patients aged between 18 and 50 years. 2-Patients undergoing primary or diagnostic coronary angiography due to suspected or confirmed acute, chronic coronary syndrome or stable angina.

3-Patients providing written informed consent to participate in the study and discuss sexual health assessments.

Exclusion criteria

• Patients presenting with cardiogenic shock, unstable hemodynamics.
• Primary psychogenic, endocrinological (except diabetes mellitus), or neurogenic erectile dysfunction.
• Prior history of pelvic surgery, pelvic trauma, or radical prostatectomy.
• Severe hepatic failure, end-stage renal disease on dialysis, or active malignancies.
• Decompensated heart failure (NYHA Class III or IV).