Chronic heart failure (CHF) is an increasingly common cardiovascular disorder. Many
patients who have CHF report moderate to marked decreases in the frequency of sexual
activity, and up to 75% of patients report erectile dysfunction (ED). There are few
controlled clinical data on the efficacy and safety of sildenafil citrate in men who
have ED and CHF; thus, we evaluated these parameters in patients who had stable CHF.
This was a double-blind, placebo-controlled, flexible-dose study. Men who had ED and
stable CHF were randomized to receive sildenafil or placebo for 12 weeks. Primary
outcomes were questions 3 and 4 of the International Index of Erectile Function. Secondary
outcomes included the 5 functional domains of the International Index of Erectile
Function, 2 global efficacy assessment questions, intercourse success rate, the Erectile
Dysfunction Inventory of Treatment Satisfaction, and the Life Satisfaction Checklist.
By week 12, patients who received sildenafil (n = 60) showed significant improvements
on questions 3 and 4 compared with patients who received placebo (n = 72; p <0.002).
Larger percentages of patients who received sildenafil reported improved erections
(74%) and improved intercourse (68%) compared with patients who received placebo (18%
and 16%, respectively). Intercourse success rates were 53% among patients who received
sildenafil and 20% among those who received placebo. Patients who received sildenafil
were highly satisfied with treatment and their sexual life compared with patients
who received placebo. Sixty percent of patients who received sildenafil and 48% of
patients who received placebo developed adverse events, including transient headache,
facial flushing, respiratory tract infection, and asthenia. The incidence of events
related to cardiovascular effects was low. Sildenafil is an effective and well-tolerated
management of ED in men who have mild to moderate CHF.
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Article info
Publication history
Accepted:
August 26,
2004
Received:
July 14,
2004
Footnotes
This study was supported by Pfizer, Inc., New York, New York.
Identification
Copyright
© 2005 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
