A Novel Machine Learning-Based Risk Classification for Vascular Damage in Men with Erectile Dysfunction

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I (MP47)1 May 2024MP47-05 A NOVEL MACHINE LEARNING-BASED RISK CLASSIFICATION FOR VASCULAR DAMAGE IN MEN WITH ERECTILE DYSFUNCTION Federico Belladelli, Edoardo Pozzi, Christian Corsini, Alessandro Bertini, Massimiliano Raffo, Fausto Negri, Francesco Cattafi, Marco Oddo, Marco Malvestiti, Riccardo Ramadani, Luigi Candela, Paolo Capogrosso, Luca Boeri, Leutrim Zahiti, Agostino Mattei, Alessia d'Arma, Federico Dehò, Francesco Montorsi, and Andrea Salonia Federico BelladelliFederico Belladelli , Edoardo PozziEdoardo Pozzi , Christian CorsiniChristian Corsini , Alessandro BertiniAlessandro Bertini , Massimiliano RaffoMassimiliano Raffo , Fausto NegriFausto Negri , Francesco CattafiFrancesco Cattafi , Marco OddoMarco Oddo , Marco MalvestitiMarco Malvestiti , Riccardo RamadaniRiccardo Ramadani , Luigi CandelaLuigi Candela , Paolo CapogrossoPaolo Capogrosso , Luca BoeriLuca Boeri , Leutrim ZahitiLeutrim Zahiti , Agostino MatteiAgostino Mattei , Alessia d'ArmaAlessia d'Arma , Federico DehòFederico Dehò , Francesco MontorsiFrancesco Montorsi , and Andrea SaloniaAndrea Salonia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008880.11564.10.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Diagnostic role of penile dynamic colour Doppler duplex ultrasound (CDDU) erectile dysfunction (ED) is still debated. However, vasculogenic ED is considerably associated with the risk of new cardiovascular (CV) events. We aimed to develop a new vascular risk classification based on a cohort of patients diagnosed with ED. METHODS: CDDU data from 301 consecutive ED patients were prospectively collected at a single academic center. Baseline data included: age, known cardiovascular risk factors, BMI, smoking and alcohol habits. All patients completed the International Index of Erectile Function – erectile function (IIEF-EF) domain scores. V-ED was defined as a peak systolic velocity <35 cm/s and a resistance index <0.8. We relied on Chi-square Automatic Interaction Detectors (CHAID), a recursive machine learning partitioning algorithm to identify risk groups for V-ED. ROC curve was applied to test the accuracy of the prediction for the risk classification. Using retrospectively collected data from a second cohort of 127 men diagnosed and treated for ED, the risk groups were tested as predictors of response to ED treatment and the onset of new major CV events using logistic, cox regression models and Kaplan Meier curves. RESULTS: Median (IQR) age was 45 (30-58) years and BMI was 24.5 (22.5-26.8) kg/m2. Of all, 27% (n=81) were active smokers. At CDDU, V-ED was detected in 107 (36%) patients. The CHAID identified five groups: i) age <53 years and BMI <25 kg/m2; ii) age <53 years, BMI >25 kg/m2 and non-smoker; iii) age ≥53 years and non-smoker; iv) age <53 years, BMI >25 kg/m2 and smoker; v) age >53 years and smoker. We named those groups as very low-, low-, moderate-, high-risk and very high-risk for V-ED (Figure 1A). Using the second cohort of patients, high-risk (OR: 4.29; 1.46-13.53; p=0.030) and very high-risk groups (OR: 5.55; 2.16-15.85; p=0.004) emerged to be associated with ED treatment response, whilst very high-risk group (HR: 4.00; 1.06-15.08; p=0.041) resulted predictor of new CV events (Figure 1B). CONCLUSIONS: We identified five risk classes for vascular damage in ED patients. "Very High Risk" and "High Risk" patients should be considered as ideal candidates for CDDU, being at a major risk of V-ED with poor respond to ED therapy. Additionally, "Very High Risk" patients are at 30% risk of developing CVD within ten years. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e764 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Federico Belladelli More articles by this author Edoardo Pozzi More articles by this author Christian Corsini More articles by this author Alessandro Bertini More articles by this author Massimiliano Raffo More articles by this author Fausto Negri More articles by this author Francesco Cattafi More articles by this author Marco Oddo More articles by this author Marco Malvestiti More articles by this author Riccardo Ramadani More articles by this author Luigi Candela More articles by this author Paolo Capogrosso More articles by this author Luca Boeri More articles by this author Leutrim Zahiti More articles by this author Agostino Mattei More articles by this author Alessia d'Arma More articles by this author Federico Dehò More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF downloadLoading ...