madman
Super Moderator
Key Question
What are the effects of phosphodisesterase-5 inhibitors (PDE5i) on hard cardiovascular endpoints and overall mortality?
Key Finding
Over a median follow-up period of 4.3 years, this pooled analysis of 16 studies demonstrated that the risk of major adverse cardiovascular events and all-cause mortality was reduced by 22% and 30%, respectively, in patients exposed to PDEi compared to controls.
Take-home Message
The use of PDE5i provides important clinical benefits that extend beyond erectile dysfunction and include cardioprotective effects and improved AMI, acute myocardial infarction; survival.
*This is the first meta-analysis to fully assess the long-term effects of PDE5i on hard cardiovascular endpoints. The major finding of our analysis is that the use of PDE5i is associated with a reduction of 22% in MACE and 30% in all-cause mortality primarily in middle-aged men with a rather elevated baseline risk for cardiovascular events. Interestingly, this beneficial seems to be maintained in patients with known, stable coronary artery disease. Indeed, ED represents an independent risk factor for the development of future clinical cardiovascular events15. It is now well established that ED and CAD share mutual vascular risk factors along with common pathogenic features, dominated by vascular endothelial dysfunction3839. PDE5i restore endothelial function predominantly through the enhancement of nitric oxide viability, inducing the appropriate endothelial-dependent vasorelaxation that is necessary to obtain an erection. Theoretically, owing to their mechanism of action, PDE5i could optimally be suitable for the treatment of cardiovascular disorders.
