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Long-term effects of phosphodiesterase-5 inhibitors on cardiovascular outcomes and death: a systematic review and meta-analysis.
- Source :
-
European heart journal. Cardiovascular pharmacotherapy [Eur Heart J Cardiovasc Pharmacother] 2024 Aug 14; Vol. 10 (5), pp. 403-412. - Publication Year :
- 2024
-
Abstract
- Aims: Phosphodiesterase 5 inhibitors (PDE5i), which are widely used for the treatment of erectile dysfunction (ED), have been found to exhibit systemic vascular benefits by improving endothelial function. In this context, we sought to evaluate the effects of PDE5i on long-term cardiovascular outcomes and mortality.<br />Methods and Results: A comprehensive search of electronic databases was conducted up to 30 May 2023. Cohort studies comparing PDE5i treatment at any dose with other ED treatment, placebo or no treatment and minimum follow-up duration of 6 months were considered eligible. The primary endpoints were: (1) major adverse cardiovascular events (MACE) and (2) all-cause mortality. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. Sixteen studies were included (1 257 759 subjects-10.5% treated with PDE5i). The majority of patients (99.4%) were men [median age 61.5 years (range 30-72.8)]. The median follow-up duration was 4.3 years (range 6 months-7.5 years). PDE5i use was associated with a significant reduction in the composite of MACE (RR 0.78, 95% CI 0.69-0.89). Moreover, the analysis of pooled data from 13 studies, demonstrated that the use of PDE5i was associated with a significantly lower risk of all-cause mortality (RR 0.70, 95% CI 0.56-0.87).<br />Conclusion: The use of PDE5i primarily in men with or without known coronary artery disease was associated with a lower risk for cardiovascular events and overall mortality. This information underlines that PDE5i could provide clinical benefit beyond ED treatment and could instigate the conduction of further, large-scale randomized clinical trials.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Subjects :
- Humans
Male
Time Factors
Treatment Outcome
Middle Aged
Aged
Risk Assessment
Adult
Female
Risk Factors
Phosphodiesterase 5 Inhibitors adverse effects
Phosphodiesterase 5 Inhibitors therapeutic use
Cardiovascular Diseases mortality
Cardiovascular Diseases drug therapy
Cardiovascular Diseases diagnosis
Cardiovascular Diseases prevention & control
Erectile Dysfunction drug therapy
Erectile Dysfunction mortality
Cause of Death
Subjects
Details
- Language :
- English
- ISSN :
- 2055-6845
- Volume :
- 10
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European heart journal. Cardiovascular pharmacotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 38777751
- Full Text :
- https://doi.org/10.1093/ehjcvp/pvae029