Abstract
Background: Patients with acute ST-elevation myocardial infarction (STEMI) face high rates of mortality and morbidity. Development of erectile dysfunction (ED) after STEMI is a common adverse effect. The study aimed to evaluate the effect of reperfusion strategy (primary percutaneous coronary intervention (PPCI) or fibrinolytic therapy (FT)) on erectile function in STEMI patients.
Patients and Methods: This observational study included 300 male patients with recent STEMI treated with either FT (FT-treated group, 128 patients) or PPCI (PPCI-treated group, 172 patients). Erectile function was evaluated using the International Index of Erectile Function 5-item (IIEF-5) during the patient's hospital stay to assess erectile function in the past three months and then 6 months after STEMI.
Results: There was a significant reduction in the post-STEMI IIEF-5 score in patients of the FT-treated group than those of the PPCI-treated group (p < 0.001), and this was confirmed by the distribution of IIEF-5 categories (p = 0.037). Reperfusion strategy, age, smoking, heart rate on admission, left ventricular internal diameter end-systole, and hypertension were independent predictors of post-STEMI IIEF-5 score.
Conclusion: PPCI was associated with a lower prevalence of ED following STEMI compared to FT. Furthermore, older age, smoking, hypertension, elevated heart rate on admission, and enlarged LVIDs were associated with deterioration of erectile function after STEMI.