{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T16:25:26Z","timestamp":1770481526351,"version":"3.49.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T00:00:00Z","timestamp":1322697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,12,1]]},"abstract":"<jats:title>ABSRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Intracavernous alprostadil injection (ICI) test has been considered useless in assessing the vascular status of subjects with erectile dysfunction (ED).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To analyze the clinical correlates of ICI test in patients with ED and to verify the value of this test in predicting major adverse cardiovascular events (MACE).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A consecutive series of 2,396 men (mean age 55.9\u2003\u00b1\u200311.9 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (N\u2003=\u20031,687) was enrolled in a longitudinal study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Several clinical, biochemical, and instrumental (penile color Doppler ultrasound; PCDU) factors were evaluated. All patients underwent an ICI test, and responses were recorded on a four-point scale ranging from 1\u2003=\u2003no response to 4\u2003=\u2003full erection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the patients studied, 16.4%, 41.2%, 40.2% and 2.2% showed grade 4, 3, 2, and 1 ICI test response, respectively. After adjusting for confounders, subjects with grade 1 ICI test response showed reduced perceived sleep-related, masturbation-related, and sexual-related erections when compared with the rest of the sample. In addition, a worse response to ICI test was associated with a higher prevalence of hypogonadism-related symptoms and signs along with lower testosterone levels. The prevalence of both diabetes mellitus and metabolic syndrome was inversely related to ICI test response. Accordingly, dynamic and basal peak systolic velocity (PSV), as well as acceleration at PCDU, decreased as a function of ICI test response. In the longitudinal study, after adjusting for confounders, grade 1 response was independently associated with a higher incidence of MACE (hazard ratio\u2003=\u20032.745\u2003[1.200\u20136.277]; P\u2003&amp;lt;\u20030.05). These data were confirmed even when only subjects with normal PSV (&amp;gt;25\u2003cm\/s) were considered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results demonstrate that poor ICI test response is associated with several metabolic disturbances and higher incidence of MACE. We strongly recommend performing ICI test with alprostadil in all ED subjects.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/j.1743-6109.2011.02474.x","type":"journal-article","created":{"date-parts":[[2011,10,13]],"date-time":"2011-10-13T18:38:47Z","timestamp":1318531127000},"page":"3433-3445","source":"Crossref","is-referenced-by-count":29,"title":["Poor Response to Alprostadil ICI Test is Associated with Arteriogenic Erectile Dysfunction and Higher Risk of Major Adverse Cardiovascular Events"],"prefix":"10.1093","volume":"8","author":[{"given":"Giulia","family":"Rastrelli","sequence":"first","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Corona","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence , Florence , Italy"},{"name":"Endocrinology Unit, Azienda Usl di Bologna, Maggiore-Bellaria Hospital , Bologna , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Monami","sequence":"additional","affiliation":[{"name":"Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Melani","sequence":"additional","affiliation":[{"name":"Epidemiological Unit, Azienda Sanitaria Locale 10 , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Balzi","sequence":"additional","affiliation":[{"name":"Epidemiological Unit, Azienda Sanitaria Locale 10 , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Sforza","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Azienda Usl di Bologna, Maggiore-Bellaria Hospital , Bologna , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianni","family":"Forti","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Mannucci","sequence":"additional","affiliation":[{"name":"Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Maggi","sequence":"additional","affiliation":[{"name":"Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence , Florence , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,12,1]]},"reference":[{"key":"2024032521550152900_bb0010","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1038\/sj.ijir.3901006","article-title":"Structured interview on erectile dysfunction (SIEDY\u00a9): A new, multi-dimensional instrument for quantification of pathogenetic issues on erectile dysfunction","volume":"15","author":"Petrone","year":"2003","journal-title":"Int J Impot Res"},{"key":"2024032521550152900_bb0015","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/13685530802468497","article-title":"Why can patients with erectile dysfunction be considered lucky? 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