TY - JOUR
T1 - Association of Erectile Dysfunction with Incident Atrial Fibrillation
T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)
AU - Tanaka, Yoshihiro
AU - Bundy, Joshua D.
AU - Allen, Norrina B.
AU - Uddin, S. M.Iftekhar
AU - Feldman, David I.
AU - Michos, Erin D.
AU - Heckbert, Susan R.
AU - Greenland, Philip
N1 - Funding Information:
Funding: The MESA cohort study is funded by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 and by grant HL127659 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from National Center for Advancing Translational Science. YT was supported by American Heart Association Strategically Focused Research Network (SFRN), 18SFRN34110170. JDB was supported by the National Institutes of Health/National Heart, Lung, and Blood Institute Cardiovascular Epidemiology training grant T32HL069771.
PY - 2020/5
Y1 - 2020/5
N2 - Purpose: Erectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established. This study aimed to determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors. Methods: We studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using 3 models in which variables were added in a stepwise manner. In model 3, HR was adjusted for age, race and ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate. Results: During the median follow-up of 3.8 (interquartile range, 3.5-4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between males with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, P < .01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (model 3; HR, 1.66; 95% confidence interval 1.01-2.72, P y= .044). Conclusions: Among older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.
AB - Purpose: Erectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established. This study aimed to determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors. Methods: We studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using 3 models in which variables were added in a stepwise manner. In model 3, HR was adjusted for age, race and ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate. Results: During the median follow-up of 3.8 (interquartile range, 3.5-4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between males with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, P < .01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (model 3; HR, 1.66; 95% confidence interval 1.01-2.72, P y= .044). Conclusions: Among older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.
KW - Atherosclerosis
KW - Atrial fibrillation
KW - Erectile dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85080142543&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85080142543&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2019.08.052
DO - 10.1016/j.amjmed.2019.08.052
M3 - Article
C2 - 31743659
AN - SCOPUS:85080142543
VL - 133
SP - 613-620.e1
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 5
ER -