The following is a summary of “Association of tadalafil exposure with lower rates of major adverse cardiovascular events and mortality in a general population of men with erectile dysfunction,” published in the February 2024 issue of Cardiology by Kloner et al.

Tadalafil, a phosphodiesterase-5 inhibitor (PDE-5i), is prescribed for the treatment of erectile dysfunction (ED) due to its long-acting properties.

Researchers conducted a retrospective study to assess whether tadalafil usage decreases the likelihood of major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, coronary revascularization, unstable angina, heart failure, and stroke, as well as all-cause mortality, among men diagnosed with ED.

They conducted a retrospective observational cohort study using a substantial US commercial insurance claims database comprising men diagnosed with ED but no prior MACE within one year. The exposed group (n = 8,156) had at least one claim for tadalafil individuals, while the unexposed group (n = 21,012) had no claims for any PDE-5i. 

The results showed that among men exposed to tadalafil compared to those unexposed to any PDE-5i, there was a 19% lower adjusted rate of MACE (HR = 0.81; 95% CI = 0.70−0.94; P=.007) over a mean follow-up of 37 months for the exposed group and 29 months for the unexposed group. Tadalafil exposure was also linked to lower adjusted rates of coronary revascularization (HR = 0.69; 95% CI = 0.52−0.90; P=.006), unstable angina (HR = 0.55; 95% CI = 0.37−0.81; P=.003), and cardiovascular-related mortality (HR = 0.45; CI = 0.22−0.93; P=.032). ORR was 44% lower in men exposed to tadalafil (HR = 0.56; CI = 0.43−0.74; P<.001). Those in the highest quartile of tadalafil exposure had the lowest rates of MACE (HR: 0.40; 95% CI: 0.28−0.58; P<.001) compared to the lowest exposure quartile.

Investigators concluded that men with ED taking tadalafil experienced substantially lower rates of MACE and death compared to those not taking the medication. 

Source: onlinelibrary.wiley.com/doi/full/10.1002/clc.24234