Evidence map›Paper›PMID 38777751›Full record

SynthesisEuropean heart journal. Cardiovascular pharmacotherapy2024

Long-term effects of phosphodiesterase-5 inhibitors on cardiovascular outcomes and death: a systematic review and meta-analysis.

Stergios Soulaidopoulos, Dimitrios Terentes-Printzios, Nikolaos Ioakeimidis, Konstantinos P Tsioufis, Charalambos Vlachopoulos

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal. Cardiovascular pharmacotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Review
  7. Review
  8. Article
  9. Treatment With Phosphodiesterase 5 Inhibitors and Long-Term Outcomes in Patients Undergoing Coronary Angiography and Cardiac Catheterization.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Article
  10. The impact of PDE5 inhibitors on cardiovascular outcomes.Global cardiology science & practice · 2025
    Review
  11. Bleeding and thrombosis.European heart journal. Cardiovascular pharmacotherapy · 2025
    Article
  12. Review
  13. Review
  14. Potential beneficial impacts of tadalafil on cardiovascular diseases.Journal of the Chinese Medical Association : JCMA · 2025
    Review
  15. Article
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Stergios SoulaidopoulosFirst Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0003-4150-5286
Dimitrios Terentes-PrintziosFirst Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0003-4039-8263
Nikolaos IoakeimidisFirst Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Konstantinos P TsioufisFirst Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Charalambos VlachopoulosFirst Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.ORCID 0000-0002-9904-3558

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPhosphodiesterase 5 inhibitors (PDE5i), which are widely used for the treatment of erectile dysfunction (ED), have been found to exhibit systemic vascular benefits by improving endothelial function. In this context, we sought to evaluate the effects of PDE5i on long-term cardiovascular outcomes and mortality. METHODS AND

resultsA comprehensive search of electronic databases was conducted up to 30 May 2023. Cohort studies comparing PDE5i treatment at any dose with other ED treatment, placebo or no treatment and minimum follow-up duration of 6 months were considered eligible. The primary endpoints were: (1) major adverse cardiovascular events (MACE) and (2) all-cause mortality. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. Sixteen studies were included (1 257 759 subjects-10.5% treated with PDE5i). The majority of patients (99.4%) were men [median age 61.5 years (range 30-72.8)]. The median follow-up duration was 4.3 years (range 6 months-7.5 years). PDE5i use was associated with a significant reduction in the composite of MACE (RR 0.78, 95% CI 0.69-0.89). Moreover, the analysis of pooled data from 13 studies, demonstrated that the use of PDE5i was associated with a significantly lower risk of all-cause mortality (RR 0.70, 95% CI 0.56-0.87).

conclusionThe use of PDE5i primarily in men with or without known coronary artery disease was associated with a lower risk for cardiovascular events and overall mortality. This information underlines that PDE5i could provide clinical benefit beyond ED treatment and could instigate the conduction of further, large-scale randomized clinical trials.

Indexed as

Cardiovascular DiseasesCause of DeathErectile DysfunctionPhosphodiesterase 5 InhibitorsAdultAgedFemaleHumansMaleMiddle AgedRisk AssessmentRisk FactorsTime FactorsTreatment OutcomePhosphodiesterase 5 InhibitorsCardiovascular diseaseCoronary artery diseaseErectile dysfunctionMortalityPhosphodiesterase 5 inhibitorsSildenafil

Identifiers

PMID38777751
PMCPMC11323371

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.