Impact of antiplatelet therapy on erectile dysfunction following percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.

Authors

Joongwon Choi, Chung Un Lee, Hyun Woong Park, Jung Hoon Kim, Yong Seong Lee, Jong-Hwa Ahn, Jin Sin Koh, Min Gyu Kang, Weon Kim, Udaya S Tantry, Paul A Gurbel, Jin-Yong Hwang, Young-Hoon Jeong

Published in

Frontiers in medicine. Volume 13. Pages 1874442. Epub Sep 03, 2026.

Abstract

Acute myocardial infarction (AMI) is strongly associated with erectile dysfunction (ED). This study evaluated the association between P2Y₁₂ receptor inhibitor type and ED, and factors associated with moderate-to-severe ED in high-risk patients with AMI.
The HEALING-AMI trial randomized patients with naïve ST-segment elevation myocardial infarction (STEMI) to dual antiplatelet therapy (DAPT) with either ticagrelor or clopidogrel. This substudy included 59 male patients who completed 6 months of DAPT (ticagrelor, n = 30; clopidogrel, n = 29). Erectile function [International Index of Erectile Function-5 (IIEF-5)], Bleeding Academic Research Consortium (BARC) bleeding, and dyspnoea were assessed using standardized questionnaires.
At 6-month follow-up, moderate-to-severe ED (IIEF-5 ≤ 11) and bleeding episodes (predominantly BARC type 1) were observed in 47.5% and 54.2%, respectively. Compared with clopidogrel, ticagrelor was associated with a lower IIEF-5 score (9.7 ± 8.8 vs. 17.0 ± 7.8, p = 0.002) and lower platelet reactivity [32 ± 67 vs. 146 ± 55 P2Y12 reaction units (PRU) measured by VerifyNow, p < 0.001]. Moderate-to-severe ED was more common in patients treated with ticagrelor than in those treated with clopidogrel (63.3% vs. 31.0%). Bleeding episodes and platelet reactivity were also significantly associated with moderate-to-severe ED. In multivariable analysis, both P2Y₁₂ inhibitor type and bleeding episodes were independently associated with moderate-to-severe ED. After multivariable adjustment, ticagrelor-treated patients who experienced bleeding had an approximately 5.6-fold higher odds of moderate-to-severe ED than clopidogrel-treated patients without bleeding (95% CI 1.052-30.087, p = 0.044).
In male patients with STEMI, moderate-to-severe ED and bleeding episodes were common during DAPT. P2Y₁₂ inhibitor type (ticagrelor vs. clopidogrel) and bleeding episodes were associated with moderate-to-severe ED.

PMID:
42755832
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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