TY - JOUR
T1 - Erectile dysfunction and cardiovascular risk in men with rheumatoid arthritis
T2 - A population-based cohort study
AU - Wilton, Katelynn M.
AU - Achenbach, Sara J.
AU - Davis, John M.
AU - Myasoedova, Elena
AU - Matteson, Eric L.
AU - Crowson, Cynthia S.
N1 - Funding Information:
KMW was supported by the National Institutes of General Medical Sciences (grant T32-GM-65841) and is supported by the Mayo Clinic College of Medicine’s Medical Scientist Training Program. This work was funded by a grant from the National Institutes of Health (NIH), National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR46849). Research reported in this publication was supported by the National Institute of Aging of the NIH under Award Number R01AG034676 and grant number UL1TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. 1K.M. Wilton, BS, Medical Scientist Training Program, Mayo Clinic College of Medicine and Science; 2S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine and Science; 3J.M. Davis III, MD, MS, Division of Rheumatology, Mayo Clinic College of Medicine and Science; 4E. Myasoedova, MD, PhD, E.L. Matteson, MD, Division of Rheumatology, and Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science; 5C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. JMD has received consulting fees and/or honoraria from AbbVie and Sanofi-Genzyme (< $10,000 each) and research support from Pfizer. The other authors declare no conflict of interest relevant to this article. Address correspondence to Dr. C.S. Crowson, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA. Email: Crowson@mayo.edu. Accepted for publication December 16, 2020.
Publisher Copyright:
© 2021 Journal of Rheumatology. All rights reserved.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Objective. Both erectile dysfunction (ED) and rheumatoid arthritis (RA) are associated with increased cardiovascular (CV) risk. It is unknown if these diagnoses are associated or if their combination confers additional CV risk. We aimed to define the incidence of ED in RA, and to determine if ED correlates with increased CV risk in RA. Methods. Medical information concerning RA, ED, and CV diagnoses for men with RA (n = 260) diagnosed in Olmsted County, Minnesota, and age-matched male comparators was extracted from a comprehensive medical record system. Results. ED incidence was similar between the RA cohort and comparators (HR 0.80, 95% CI 0.55-1.16). In men with RA, ED diagnosis was associated with a trend toward an increase in peripheral arterial disease (HR 2.22, 95% CI 0.98-5.03) and a significantly decreased rate of myocardial infarction (HR 0.26, 95% CI 0.07-0.90), heart failure (HR 0.49, 95% CI 0.25-0.94), and death (HR 0.56; 95% CI 0.36-0.87). In men with RA and ED, phosphodiesterase-5 inhibitor use was associated with a decreased risk of death (HR 0.35, 95% CI 0.16-0.79), with a trending decreased risk of some CV diagnoses. Conclusion. Incidence of ED was not statistically increased in RA. Although patients with both RA and ED had a similar overall CV risk to those with RA alone, men with both RA and ED had decreased risk of heart failure, myocardial infarction, and death, as well as an increased risk of peripheral arterial disease. Further studies are needed to clarify these associations and their implications for pathogenesis and therapeutics.
AB - Objective. Both erectile dysfunction (ED) and rheumatoid arthritis (RA) are associated with increased cardiovascular (CV) risk. It is unknown if these diagnoses are associated or if their combination confers additional CV risk. We aimed to define the incidence of ED in RA, and to determine if ED correlates with increased CV risk in RA. Methods. Medical information concerning RA, ED, and CV diagnoses for men with RA (n = 260) diagnosed in Olmsted County, Minnesota, and age-matched male comparators was extracted from a comprehensive medical record system. Results. ED incidence was similar between the RA cohort and comparators (HR 0.80, 95% CI 0.55-1.16). In men with RA, ED diagnosis was associated with a trend toward an increase in peripheral arterial disease (HR 2.22, 95% CI 0.98-5.03) and a significantly decreased rate of myocardial infarction (HR 0.26, 95% CI 0.07-0.90), heart failure (HR 0.49, 95% CI 0.25-0.94), and death (HR 0.56; 95% CI 0.36-0.87). In men with RA and ED, phosphodiesterase-5 inhibitor use was associated with a decreased risk of death (HR 0.35, 95% CI 0.16-0.79), with a trending decreased risk of some CV diagnoses. Conclusion. Incidence of ED was not statistically increased in RA. Although patients with both RA and ED had a similar overall CV risk to those with RA alone, men with both RA and ED had decreased risk of heart failure, myocardial infarction, and death, as well as an increased risk of peripheral arterial disease. Further studies are needed to clarify these associations and their implications for pathogenesis and therapeutics.
KW - Cardiovascular risk
KW - Epidemiology
KW - Erectile dysfunction
KW - Peripheral arterial disease
KW - Rheumatoid arthritis
KW - Sexual health
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UR - http://www.scopus.com/inward/citedby.url?scp=85120078750&partnerID=8YFLogxK
U2 - 10.3899/jrheum.201226
DO - 10.3899/jrheum.201226
M3 - Article
C2 - 33452166
AN - SCOPUS:85120078750
SN - 0315-162X
VL - 48
SP - 1641
EP - 1647
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 11
ER -