# Treatment With Phosphodiesterase 5 Inhibitors and Long‐Term Outcomes in Patients Undergoing Coronary Angiography and Cardiac Catheterization

## TL;DR

This study found that using PDE5 inhibitors does not increase the risk of major cardiovascular events in patients undergoing heart procedures.

## Contribution

The study provides new evidence on the long-term cardiovascular safety of PDE5 inhibitors in a clinical setting.

## Key findings

- PDE5 inhibitor users had a lower MACE rate compared to non-users before matching.
- After matching, no significant difference in MACE was found between the groups.
- Multivariable analysis showed no significant association between PDE5 inhibitors and MACE.

## Abstract

The effects of phosphodiesterase 5 (PDE5) inhibitors on the incidence of long‐term outcomes in patients with cardiovascular disease are not well understood. Objective: We studied the association between PDE5 inhibitor therapy and the incidence of adverse cardiovascular major adverse cardiovascular events (MACE) in patients undergoing coronary angiography and intervention.

We studied 4582 consecutive patients undergoing coronary angiography and intervention. The incidence of MACE at 1 year, defined as urgent revascularization, myocardial infarction, admission for heart failure or all‐cause death, was considered the primary outcome.

Of the 4582 patients, 562 (12.3%) had current prescriptions for PDE5 inhibitors before the procedure and 4020 (87.7%) did not. The incidence of MACE was 171 (30.4%) among patients of the PDE5 inhibitor group versus 1482 (36.9%) in the non‐PDE5 inhibitor group (p = 0.003). In a propensity score‐matched analysis of 1124 of patients, 171 (30.4%) patients in the PDE5i group and 175 (31.1%) patients in the non‐PDE5i group had a MACE (p = 0.84). On multivariable analysis, the treatment with PDE5 inhibitors was not significantly associated with the risk of MACE (odds ratio [OR] = 0.99, 95% CI 0.93–1.06; p = 0.86).

In this cohort of veterans undergoing coronary angiography/cardiac catheterization, chronic PDE5i therapy was not associated with an increased risk of MACE at 1 year.