@article {Andersson1264, author = {Daniel P Andersson and Ylva Trolle Lagerros and Alessandra Grotta and Rino Bellocco and Mikael Lehtihet and Martin J Holzmann}, title = {Association between treatment for erectile dysfunction and death or cardiovascular outcomes after myocardial infarction}, volume = {103}, number = {16}, pages = {1264--1270}, year = {2017}, doi = {10.1136/heartjnl-2016-310746}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective Erectile dysfunction (ED) is associated with an increased risk of cardiovascular disease in healthy men. However, the association between treatment for ED and death or cardiovascular outcomes after a first myocardial infarction (MI) is unknown.Methods In a Swedish nationwide cohort study all men \<80 years of age without prior MI, or cardiac revascularisation, hospitalised for MI during 2007{\textendash}2013 were included. Treatment for ED, defined as dispensed phosphodiesterase-5 inhibitors or alprostadil, was related to risk of death, MI, cardiac revascularisation or heart failure.Results Forty-three thousand one hundred and forty-five men with mean age 64 ({\textpm}10) years were included, of whom 7.1\% had ED medication dispensed during a mean 3.3 years (141 739 person-years) of follow--up. Men with, compared with those without treatment for ED, had a 33\% lower mortality (adjusted HR 0.67 (95\%CI 0.55 to -0.81)), and 40\% lower risk of hospitalisation for heart failure (HR 0.60 (95\% CI 0.44 to 0.82)). There was no association between treatment with alprostadil and mortality. The adjusted risk of death in men with 1, 2{\textendash}5 and \>5 dispensed prescriptions of phosphodiesterase-5 inhibitors was reduced by 34\% (HR 0.66 (95\% CI 0.38 to 1.15), 53\% (HR 0.47 (95\% CI 0.26 to 0.87) and 81\% (HR 0.19 (95\% CI 0.08 to 0.45), respectively, when compared with alprostadil treatment.Conclusions Treatment for ED after a first MI was associated with a reduced mortality and heart failure hospitalisation. Only men treated with phosphodiesterase-5 inhibitors had a reduced risk, which appeared to be dose-dependent.}, issn = {1355-6037}, URL = {https://heart.bmj.com/content/103/16/1264}, eprint = {https://heart.bmj.com/content/103/16/1264.full.pdf}, journal = {Heart} }