Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Increased erythrocyte aggregation in men with coronary artery disease and erectile dysfunction

International Journal of Impotence Research volume 21, pages 192–197 (2009)Cite this article

Abstract

We studied the association between erythrocyte aggregation (EA) and erectile dysfunction (ED) in men with coronary artery disease (CAD). Men with CAD documented by coronary angiography filled the Sexual Health Inventory for Males questionnaire to detect ED and assess its severity. EA was evaluated by filming slides of blood smear. Low percentage of slide field covered by erythrocytes represented increased EA. Overall, 133 men with CAD, mean ages 62.4±12.2 years, were included: 100 (75.2%) with ED and 33 (24.8%) without ED. EA was increased among men with ED compared with men without ED (percentage of slide field covered by erythrocytes 66.7±14.7 vs 73.1±14.5%; P=0.03). After adjustment for age, diabetes mellitus, hemoglobin and hematocrit levels, EA was associated with ED severity (r=0.18; P=0.038). We conclude that EA is increased in men with CAD and ED. This finding may be relevant to the pathophysiology of ED in men with CAD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Montorsi P, Ravagnani PM, Galli S, Rotatori F, Briganti A, Salonia A et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol 2005; 96: 19M–23M.

    Article  PubMed  Google Scholar 

  2. Kirby M, Jackson G, Simonsen U . Endothelial dysfunction links erectile dysfunction to heart disease. Int J Clin Pract 2005; 59: 225–229.

    Article  CAS  PubMed  Google Scholar 

  3. Stoltz JF, Donner M, Larcan A . Introduction to hemorheology: theoretical aspects and hyperviscosity syndromes. Int Angiol 1987; 6: 119–132.

    CAS  PubMed  Google Scholar 

  4. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Vasiliadou C, Alexopoulos N et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006; 27: 2640–2648.

    Article  CAS  PubMed  Google Scholar 

  5. Pryor J, Akkus E, Alter G, Jordan G, Lebret T, Levine L et al. Priapism. J Sex Med 2004; 1: 116–120.

    Article  PubMed  Google Scholar 

  6. Burnett AL, Allen RP, Tempany CM, Dover GJ, Brendler CB . Evaluation of erectile function in men with sickle cell disease. Urology 1995; 45: 657–663.

    Article  CAS  PubMed  Google Scholar 

  7. Bodie J, Lewis J, Schow D, Monga M . Laboratory evaluations of erectile dysfunction: an evidence based approach. J Urol 2003; 169: 2262–2264.

    Article  PubMed  Google Scholar 

  8. Crook L, Liu PI, Gadsden RH, Turner III RE . Erythrocyte sedimentation, viscosity, and plasma proteins in disease detection. Ann Clin Lab Sci 1980; 10: 368–376.

    CAS  PubMed  Google Scholar 

  9. Nurkalem Z, Kaya C, Orhan AL, Zencirci E, Alper AT, Kucuk E et al. Erectile dysfunction and coronary slow flow: distinct presentations of endothelial disease. Int J Impot Res 2007; 19: 610–614.

    Article  CAS  PubMed  Google Scholar 

  10. Mchedlishvili G . Disturbed blood flow structuring as critical factor of hemorheological disorders in microcirculation. Clin Hemorheol Microcirc 1998; 19: 315–325.

    CAS  PubMed  Google Scholar 

  11. Peled N, Kassirer M, Kramer MR, Rogowski O, Shlomi D, Fox B et al. Increased erythrocyte adhesiveness and aggregation in obstructive sleep apnea syndrome. Thromb Res 2008; 121: 631–636.

    Article  CAS  PubMed  Google Scholar 

  12. Samocha-Bonet D, Ben-Ami R, Shapira I, Shenkerman G, Abu-Abeid S, Stern N et al. Flow-resistant red blood cell aggregation in morbid obesity. Int J Obes Relat Metab Disord 2004; 28: 1528–1534.

    Article  CAS  PubMed  Google Scholar 

  13. Toker S, Rogowski O, Melamed S, Shirom A, Shapira I, Berliner S et al. Association of components of the metabolic syndrome with the appearance of aggregated red blood cells in the peripheral blood. An unfavorable hemorheological finding. Diabetes Metab Res Rev 2005; 21: 197–202.

    Article  PubMed  Google Scholar 

  14. Zeltser D, Serov J, Mardi T, Rogowski O, Tulshinski T, Goldin Y et al. Serum lipids as minor determinants of the degree of erythrocyte adhesiveness/aggregation in the peripheral blood of individuals with low grade inflammation and moderately increased serum lipids. Clin Hemorheol Microcirc 2004; 31: 161–167.

    CAS  PubMed  Google Scholar 

  15. Fusman R, Rotstein R, Elishkewich K, Zeltser D, Cohen S, Kofler M et al. Image analysis for the detection of increased erythrocyte, leukocyte and platelet adhesiveness/aggregation in the peripheral blood of patients with diabetes mellitus. Acta Diabetol 2001; 38: 129–134.

    Article  CAS  PubMed  Google Scholar 

  16. Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G . Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2005; 172: 613–618.

    Article  PubMed  Google Scholar 

  17. Ip MS, Tse HF, Lam B, Tsang KW, Lam WK . Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004; 169: 348–353.

    Article  PubMed  Google Scholar 

  18. Bonora E . The metabolic syndrome and cardiovascular disease. Ann Med 2006; 38: 64–80.

    Article  CAS  PubMed  Google Scholar 

  19. Corona G, Mannucci E, Petrone L, Schulman C, Balercia G, Fisher AD et al. A comparison of NCEP-ATPIII and IDF metabolic syndrome definitions with relation to metabolic syndrome-associated sexual dysfunction. J Sex Med 2007; 4: 789–796.

    Article  PubMed  Google Scholar 

  20. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  PubMed  Google Scholar 

  21. Fusman R, Zeltser D, Rotstein R, Chapman J, Avitzour D, Shapira I I et al. INFLAMET: an image analyzer to display erythrocyte adhesiveness/aggregation. Eur J Intern Med 2000; 11: 271–276.

    Article  CAS  PubMed  Google Scholar 

  22. Clauss A . Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 1957; 17: 237–246.

    Article  CAS  PubMed  Google Scholar 

  23. Rogowski O, Vered Y, Shapira I, Hirsh M, Zakut V, Berliner S . Introducing the wide range C-reactive protein (wr-CRP) into clinical use for the detection of microinflammation. Clin Chim Acta 2005; 358: 151–158.

    Article  CAS  PubMed  Google Scholar 

  24. NIH consensus development panel on impotence. JAMA 1993; 270: 83–90.

  25. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  PubMed  Google Scholar 

  26. Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–364.

    Article  PubMed  Google Scholar 

  27. Gazzaruso C, Solerte SB, Pujia A, Coppola A, Vezzoli M, Salvucci F et al. Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease: a potential protective role for statins and 5-phosphodiesterase inhibitors. J Am Coll Cardiol 2008; 51: 2040–2044.

    Article  PubMed  Google Scholar 

  28. Foroutan SK, Rajabi M . Erectile dysfunction in men with angiographically documented coronary artery disease. Urol J 2007; 4: 28–32.

    PubMed  Google Scholar 

  29. Ami RB, Barshtein G, Zeltser D, Goldberg Y, Shapira I, Roth A et al. Parameters of red blood cell aggregation as correlates of the inflammatory state. Am J Physiol Heart Circ Physiol 2001; 280: H1982–H1988.

    Article  CAS  PubMed  Google Scholar 

  30. Berliner S, Rogowski O, Aharonov S, Mardi T, Tolshinsky T, Rozenblat M et al. Erythrocyte adhesiveness/aggregation: a novel biomarker for the detection of low-grade internal inflammation in individuals with atherothrombotic risk factors and proven vascular disease. Am Heart J 2005; 149: 260–267.

    Article  CAS  PubMed  Google Scholar 

  31. Rotstein R, Landau T, Twig A, Rubinstein A, Koffler M, Justo D et al. The erythrocyte adhesiveness/aggregation test (EAAT). A new biomarker to reveal the presence of low grade subclinical smoldering inflammation in individuals with atherosclerotic risk factors. Atherosclerosis 2002; 165: 343–351.

    Article  CAS  PubMed  Google Scholar 

  32. Assayag EB, Bova I, Kesler A, Berliner S, Shapira I, Bornstein NM . Erythrocyte aggregation as an early biomarker in patients with asymptomatic carotid stenosis. Dis Markers 2008; 24: 33–39.

    Article  PubMed  Google Scholar 

  33. Shapira I, Rotstein R, Fusman R, Gluzman B, Roth A, Keren G et al. Combined leukocyte and erythrocyte aggregation in patients with acute myocardial infarction. Int J Cardiol 2001; 78: 299–305.

    Article  CAS  PubMed  Google Scholar 

  34. Shenhar-Tsarfaty S, Assayag EB, Bova I, Shopin L, Berliner S, Shapira I et al. Early signaling of inflammation in acute ischemic stroke: clinical and rheological implications. Thromb Res 2008; 122: 167–173.

    Article  CAS  PubMed  Google Scholar 

  35. Bocchio M, Desideri G, Scarpelli P, Necozione S, Properzi G, Spartera C et al. Endothelial cell activation in men with erectile dysfunction without cardiovascular risk factors and overt vascular damage. J Urol 2004; 171: 1601–1604.

    Article  PubMed  Google Scholar 

  36. Fornal M, Korbut RA, Lekka M, Pyka-Foœciak G, Wizner B, Styczen J et al. Rheological properties of erythrocytes in patients with high risk of cardiovascular disease. Clin Hemorheol Microcirc 2008; 39: 213–219.

    CAS  PubMed  Google Scholar 

  37. Muravyov AV, Yakusevich VV, Surovaya L, Petrochenko A . The effect of simvastatin therapy on hemorheological profile in coronary heart disease (CHD) patients. Clin Hemorheol Microcirc 2004; 31: 251–256.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine D, Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    D Justo, N Mashav, Y Arbel, M Kinori, A Steinvil, M Swartzon & B Molat

  2. Department of Cardiology, Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    A Halkin, A Finkelstein & S Banai

  3. Sexual Rehabilitation Clinic, Reuth Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    R Heruti

Authors
  1. D Justo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N Mashav
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y Arbel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Kinori
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Steinvil
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Swartzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B Molat
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A Halkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A Finkelstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R Heruti
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. S Banai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Justo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Justo, D., Mashav, N., Arbel, Y. et al. Increased erythrocyte aggregation in men with coronary artery disease and erectile dysfunction. Int J Impot Res 21, 192–197 (2009). https://doi.org/10.1038/ijir.2009.6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2009.6

Keywords

Search

Advanced search

Quick links