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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Erectile dysfunction: a forgotten determinant of cardiac rehabilitation program success
Session:
Posters 1 - Écran 06 - Reabilitação cardíaca
Speaker:
Helena Filipa Marinho Nascimento Guedes
Congress:
CPC 2018
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Helena M. Nascimento; J. Afonso Rocha; Marta Braga; Roberto Pinto; Marta Tavares Da Silva; Gonçalo Pestana; Paulo Araújo; Alzira Nunes; Sofia Torres; Joana Duarte Rodrigues; Vitor Araújo; Fernando Parada; Maria Júlia Maciel Barbosa
Abstract
<p><strong>Introduction: </strong>In order to improve cardiac rehabilitation program (CRP) success, it is of paramount importance to identify vulnerable groups of patients. Erectile dysfunction (ED) is a powerful indicator of cardiovascular risk and poor outcome. Therefore, our study main goal was to evaluate ED role as a predictor of functional capacity as a surrogate of CRP success.</p> <p><strong>Methods: </strong>From a registry of 840 consecutive patients(pts) enrolled in a cardiac rehabilitation program after an acute coronary syndrome (ACS), between 2008 and 2016, we studied the male pts. Sociodemographic and clinical data was prospectively collected. Depression was assessed using the Hospital Anxiety and Depression Scale (HADS) and ED through the 5-Questions International Index of Erectile Function (IIEF). ED was defined as an IIEF <17.</p> <p><strong>Results: </strong>From a total of 637 male pts studied, ED was present in 300 patients (47%). Cardiac event was a ST-elevation ACS in 45.7% and a non-ST-elevation ACS in 54.3%. ED group of pts was significantly older (56.8±9.4 vs. 52.0±9.3 years-old, p<0.001), has lower educational level (8.0±4.6 vs. 9.1±5.0, p=0.005) and higher levels of HADS-depression (5.1±3.9 vs. 3.6±3.7, p<0.001). Regarding the cardiovascular risk factor, hypertension and diabetes were significantly more prevalent in ED pts (p<0.005). Also, coronary artery disease was more severe in this group (number of coronary vessel disease: 1.5±0.8 vs. 1.3±0.6, p=0.001). In terms of functional capacity, the ED pts performed worse both at the beginning (METs 8.6±2.3 vs. 9.5±2.2, p<0.001) and at the end of the CRP (METs 10.2±2.0 vs. 11.4±2.4, p<0.001). Nevertheless, the CRP program significantly improved the functional capacity (degree of METs improvement 1.6±1.8, p<0.001) and reduced the HADS-depression levels (1.1±4.2, p=0.014) in these pts.</p> <p><strong>Conclusion: </strong>ED is a highly prevalent condition in ACS population and its impact on quality of life is undeniable. Moreover, it must be recognized as a predictor of poorer performance in CRP programs. Therefore, sexual function assessment should integrate ACS patient evaluation, and tailored strategies ought to be conceived in order to achieve CRP success.</p>
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