Baseline atrial fibrillation is a risk factor for erectile dysfunction: Systemic review and meta-analysis

Objective: To assess the association between atrial fibrillation (AF) and erectile dysfunction (ED) by a systematic review of the literature and meta-analysis, as ED is commonly found amongst male patients with concurrent cardiovascular conditions, especially atherosclerosis, coronary syndrome, and diabetes; and recent studies suggest that AF is associated with ED in the general male population. Methods: Studies from inception to May 2018 in the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica dataBASE (EMBASE) were searched. Prospective or retrospective cohort studies that compared new-onset ED between male patients with and without AF were included. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios (RRs) and 95% confidence intervals (CIs). Results: Five studies from 2007 to 2016 were included in the meta-analysis involving 29829 male patients (4096 with AF and 25733 without). The presence of AF was associated with ED (pooled RR 1.61, 95% CI 1.23–2.10; P < 0.001, I² = 42%). Conclusions: Baseline AF increased the risk of ED up to 1.6-fold amongst the general male population. This suggests that AF in male patients is significantly associated with ED. Abbreviations: AF: atrial fibrillation; CV: cardiovascular; ED: erectile dysfunction; EMBASE: Excerpta Medica database; HR: hazard ratio; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; (S)IR: (standardised) incidence ratio; IIEF: International Index of Erectile Function; LVDD: left ventricular diastolic dysfunction; MEDLINE: Medical Literature Analysis and Retrieval System Online; NO: nitric oxide; OR: odds ratio; RR: relative risk.