High Sensitive Troponin in patients with Erectile Dysfunction

Gianvico Melzi D'eril1,*, Raffaele Pezzilli2, Clara Anna Linda Damele1, Rossana Stefanelli3, Giovanni M Colpi4, Massimiliano M Corsi Romanelli5, Alessandra Barassi1

1Laboratorio di Analisi, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, 2Dipartimento di Malattie dell’Apparato Digerente e Medicina Interna, Ospedale Sant'Orsola-Malpighi, Alma Mater Studiorum, Università degli Studi di Bologna, Bologna, 3Laboratorio di Analisi, Ospedale San Paolo, 4ISES – Istituto per la Sterilità e la Sessualità, Milan, 5Unità Operativa Medicina di Laboratorio -1 Patologia Clinica, IRCCS Policlinico San Donato, San Donato, Italy

Introduction: Evidence is accumulating in favour of a link between erectile dysfunction and coronary artery diseases. Cardiac troponin with a new high-sensitivity (hs-Tn) assay has a strong association with coronary artery diseases, mortality, and heart failure. 

Objectives: The aim of the study was to investigate the presence of cardiac injury in patients who have had arteriogenic and non arteriogenic erectile dysfunction for less than one year using the hs-Tn levels.

Methods: The diagnosis of erectile dysfunction was based on the International Index of Erectile Function 5-questionnaire and patients were classified as arteriogenic (no. 40), non arteriogenic (no. 48), and borderline (no. 32) patients in relation to the results of echo-color-doppler examination of cavernous arteries in basal conditions and after an intracavernous injection of 10 mg prostaglandin E1. Hs-TnT and hs-TnI levels were measured in 120 men with a history of erectile dysfunction of less than one year with no clinical evidence of cardiac ischemic disease.

Results: The levels of both hs-TnT and hs-TnI were all within the reference range and there was no significant (P<0.05) difference between patients of the three groups. The hs-CRP values were higher in A-ED men compared with NA-ED (P=0.048), but not compared with BL-ED (P=0.136), and negatively correlated with International Index of Erectile Function questionnaire (r=-0.480; P=0.031).

Conclusion: This study shows that the measurement of hs-TnT or hs-TnI levels allows us to exclude the presence of cardiovascular disease in patients with ED. The reason is probably the short history of ED, which was of less than one year. Longitudinal study is currently in progress to follow the level of hs-Tn (I and T) in this selected group of men, particularly in A-ED, in order to recognize when the heart begins to be affected by the process of atherosclerosis, before clinical symptoms.

Keywords: Biomarker, Cardiovascular, Heart