Endocrine Abstracts

Introduction: The Atherosclerosis Risk in Communities (ARIC) algorithm is one of the most efficient instruments for the prediction of incident type 2 diabetes (T2DM). Recently it has been shown to predict another relevant cardiovascular (CV) risk factor, such as chronic kidney disease.

The aim of the present study is to verify whether, in patients with erectile dysfunction (ED), the use of ARIC diabetes risk score might improve the efficacy in predicting major CV events of other CV risk algorithms specifically developed for the assessment of CV risk.

Methods: A consecutive series of 2437 men (mean age 52.5±12.9 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (n=1687) was enrolled in a longitudinal study (mean follow up of 4.3±2.6 years). The assessment of metabolic risk was evaluated with the ARIC algorithm. The assessment of CV risk was evaluated using the Progetto Cuore risk engine.

Results: In the cross sectional study ARIC score was inversely related with testosterone levels, sexual functioning and penile blood flow. When longitudinal sample was analyzed, higher baseline ARIC score significantly predicted MACE even when subjects with diabetes mellitus at baseline were excluded from the analysis (HR=1.522 (1.086–2.135), P=0.015 for trend). In addition, among subjects classified as ‘low-risk’ (CV risk <20% at 10 years corresponding to <9% at 4.3 years) by Progetto Cuore, a ROC curve analysis for ARIC (vs MACE) allowed the identification of a threshold of 0.22, which had a positive predictive value for 4.3-year MACE of 9%. Applying the ARIC score (with a threshold of 0.22) to Progetto Cuore ‘low risk’ subjects, we could classify as ‘at high risk’ 89.8% of subjects with incident MACE vs 79.6% with Progetto Cuore only.

Conclusions: In patients with ED identifying pre-diabetes, even with algorithms, predicts long-term CV events.