Article révisé par les pairs
Résumé : Objectives: Recognition of erectile dysfunction (ED) as an early sign of systemic cardiovascular disease offers an opportunity for prevention. Cardiac risk assessment may deserve measurement of Apolipoprotein B/Apolipoprotein A-1 ratio. An elevated ApoB/ApoA-1 ratio is a risk factor for future coronary artery disease. ApoA-1 production, which is recognized as a cardioprotective lipid fraction, is down regulated by NFκB activation in vitro. Because inhibition of phosphodiesterases (PDEs) 5, 6 and 9 negatively attenuates NFκB translocation/activation, tadalafil, a selective PDE 5 inhibitor used for treatment of ED could present some interesting pleiotropic effects. The objective of this open study is to test the hypothesis that tadalafil treatment could decrease serum ApoB/ApoA-1 ratio. Material and methods: Ten healthy men without any complain of ED or known cardiovascular risk factors were administered tadalafil 10 mg intake on alternate days for 4 weeks. Lipid profile with total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, ApoA-1 and ApoB, was assessed at baseline (T0), after 2 weeks (T1), at the end of the treatment period (T2) and after 2 weeks of wash-out follow-up (T3). Results: ApoB/ApoA-1 ratio was significantly decreased during treatment (mean ± SEM, T0: 0.80 ± 0.11, T1: 0.64 ± 0.06, T2: 0.65 ± 0.06; p < 0.05) and remained lower after wash-out (T3: 0.67 ± 0.05; p = 0.08). Serum ApoA-1 (mg/dl) increased but not significantly during the treatment period (15.2 ± 8.8, 16.5 ± 7.9, 16.9 ± 6, 15.3 ± 7, p = 0.26) and ApoB (mg/dl) significantly decreased (11.7 ± 10.8, 10.3 ± 8.4, 10.6 ± 9.9, 10.2 ± 8.6, p = 0.03). HDL and LDL cholesterol were unchanged. Conclusion: This preliminary study showed the interest of PDE 5 inhibitors to decrease the cardiac risk factor ApoB/ApoA-1 ratio. Randomised controlled studies with longer follow-up are needed to confirm those results. © 2008 Elsevier Masson SAS. All rights reserved.

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