Observational studyHeart (British Cardiac Society)2016
Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality.
Observational study in Heart (British Cardiac Society), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Associations between phosphodiesterase type 5 inhibitors and vascular function: a systematic review and meta-analysis on randomized-controlled trials.Systematic reviews · 2025Pooled it
- Long-term effects of phosphodiesterase-5 inhibitors on cardiovascular outcomes and death: a systematic review and meta-analysis.European heart journal. Cardiovascular pharmacotherapy · 2024Pooled it
- Association of erectile dysfunction and cardiovascular disease: an umbrella review of systematic reviews and meta-analyses.BJU international · 2021Pooled it
- Pooled it
- The phosphodiesterase 5 inhibitor sildenafil decreases the proinflammatory chemokine IL-8 in diabetic cardiomyopathy: in vivo and in vitro evidence.Journal of endocrinological investigation · 2019Trial
- The Role of Daily Phosphodiesterase 5 Inhibitors in the Management of Diabetic Neuropathy-The Importance of a Multidisciplinary Approach.The world journal of men's health · 2026Review
- From bedroom to boardroom: erectile dysfunction as a window into cardiovascular health.The Canadian journal of urology · 2026Review
- Evidence for the Additional Health Benefits Associated with Phosphodiesterase 5 Inhibitors when Used for Treating Erectile Dysfunction, with a Focus on Prostate Cancer Patients and Other Associated Conditions.The world journal of men's health · 2026Review
- Suppression of premature ventricular complexes with the PDE5 inhibitor sildenafil: First clinical experience.Experimental physiology · 2026Article
- Article
- Treatment With Phosphodiesterase 5 Inhibitors and Long-Term Outcomes in Patients Undergoing Coronary Angiography and Cardiac Catheterization.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Article
- Effect of long and short half-life PDE5 inhibitors on HbA1c levels: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Phosphodiesterase in heart and vessels: from physiology to diseases.Physiological reviews · 2024Review
- The association of tadalafil exposure with lower rates of major adverse cardiovascular events and mortality in a general population of men with erectile dysfunction.Clinical cardiology · 2024Observational
- Hallmarks of aging: middle-aging hypovascularity, tissue perfusion and nitric oxide perspective on healthspan.Frontiers in aging · 2024Article
- Age and the Residual Risk of Cardiovascular Disease following Low Density Lipoprotein-Cholesterol Exposure.Biomedicines · 2023Review
- Phosphodiesterase-5 Inhibitor Use in Robot Assisted Radical Prostatectomy Patients Is Associated with Reduced Risk of Death: A Propensity Score Matched Analysis of 1,058 Patients.The world journal of men's health · 2023Article
- Cardiac Effects of Phosphodiesterase-5 Inhibitors: Efficacy and Safety.Cardiovascular drugs and therapy · 2023Review
- The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, with Statements for Practice.The world journal of men's health · 2023Review
- The efficacy of PDE5 inhibitors in diabetic patients.Andrology · 2023Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study. RESEARCH DESIGN AND
methodsBetween January 2007 and May 2015, 5956 men aged 40-89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.DC1SM110.1136/heartjnl-2015-309223.supp1Supplementary appendix
resultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup.
conclusionIn a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.