{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:43Z","timestamp":1788416023029,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Acute myocardial infarction (AMI) is strongly associated with erectile dysfunction (ED). This study evaluated the association between P2Y\n                      <jats:sub>12<\/jats:sub>\n                      receptor inhibitor type and ED, and factors associated with moderate-to-severe ED in high-risk patients with AMI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The HEALING-AMI trial randomized patients with na\u00efve 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                      <jats:italic>n<\/jats:italic>\n                      = 30; clopidogrel,\n                      <jats:italic>n<\/jats:italic>\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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 6-month follow-up, moderate-to-severe ED (IIEF-5 \u2264 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 \u00b1 8.8 vs. 17.0 \u00b1 7.8,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and lower platelet reactivity [32 \u00b1 67 vs. 146 \u00b1 55 P2Y12 reaction units (PRU) measured by VerifyNow,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 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 P2Y\n                      <jats:sub>12<\/jats:sub>\n                      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\u201330.087,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In male patients with STEMI, moderate-to-severe ED and bleeding episodes were common during DAPT. P2Y\n                      <jats:sub>12<\/jats:sub>\n                      inhibitor type (ticagrelor vs. clopidogrel) and bleeding episodes were associated with moderate-to-severe ED.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1874442","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:23:26Z","timestamp":1788413006000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of antiplatelet therapy on erectile dysfunction following percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction"],"prefix":"10.3389","volume":"13","author":[{"given":"Joongwon","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Urology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong and Chung-Ang University College of Medicine","place":["Seoul, Republic of 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Seong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong and Chung-Ang University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Hwa","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Gyeongsang National University Changwon Hospital","place":["Changwon, Republic of Korea"]},{"name":"Department of Internal Medicine, Gyeongsang National University School of Medicine","place":["Jinju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Sin","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University School of Medicine","place":["Jinju, Republic of Korea"]},{"name":"Division of Cardiology, Gyeongsang National University Hospital","place":["Jinju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Gyu","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University School of Medicine","place":["Jinju, Republic of Korea"]},{"name":"Division of Cardiology, Gyeongsang National University Hospital","place":["Jinju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weon","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiovascular Department of Internal Medicine, Kyung Hee University Hospital","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udaya S.","family":"Tantry","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore","place":["MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul 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