Performance of the IIEF-5 Score for Erectile Dysfunction in Predicting Silent Myocardial Ischaemia in Patients Living with Type 2 Diabetes

Introduction: Cardiovascular complications are the leading cause of death in patients with type 2 diabetes. The pathophysiological mechanism, which is at least partly similar to that of erectile dysfunction (ED) in diabetes, suggests an association between the two conditions. Therefore, the main objective of this study was to investigate whether erectile dysfunction could be a predictive marker of silent myocardial ischaemia (SMI) in these patients. Method: We conducted a cross-sectional analytical study in men with type 2 diabetes in the Endocrinology Department of the Yaoundé Central Hospital. All adult men aged between 35 and 65 years who consented to participate were included. All those with conditions that could cause ED were excluded. ED was assessed using the IIEF-5 questionnaire, and silent myocardial ischaemia was screened for by performing a stress ECG. Bivariate analyses with odds ratios were used to study the association between ED and silent myocardial ischaemia. Results: We recruited 54 participants, with an average age of 53.9 ± 9.0 years. The average duration of diabetes was 3.1 ± 2.6 years. The prevalence of ED was 49.1% (n = 26), and it was mild in 32.1%. Participants who smoked had a higher risk of developping ED (OR = 0.67; 95% CI). The prevalence of SMI in the entire study population was 49.1%. In patients with ED, the frequency of SMI was 48.3% (n = 14), while in those without ED it was 50%. There was a non-significant association between ED and SMI (OR = 4.5; 95% CI). However, the precision-recall curves indicated that the IIEF-5 score could predict both the presence and absence of ischaemia. Conclusion: Although the IIEF-5 score has predictive value, it is not perfect and its accuracy depends on the desired level of recall.