Hemodynamic Effects of Sildenafil in Men with Severe Coronary Artery Disease

Erectile dysfunction affects up to 30 million men in the United States 1 and may be particularly common in patients with heart disease, because of the presence of overlapping risk factors, including older age, diabetes mellitus, hypertension, and hypercholesterolemia. 2 Sildenafil (Viagra, Pfizer, New York) inhibits cyclic guanosine monophosphate (cGMP)–specific phosphodiesterase type 5 in the corpus cavernosum and significantly improves erectile function and the rate of successful sexual intercourse in men with erectile dysfunction. 3 Post-marketing surveillance data after approval of sildenafil by the Food and Drug Administration revealed a number of serious cardiovascular events, including myocardial infarction and sudden death from cardiac . . .