Figure 2.

Cardiovascular risk assessment in men with vasculogenic ED and not established CVD. All patients should be evaluated for their risk of future events according to risk scores (SCORE or Framingham). Testosterone, PWV, ABI, and microalbuminuria should be used as first line tools to further characterize cardiovascular risk in men with low or intermediate risk. Additional markers such as IMT, CACS will depend on levels of first line biomarkers, availability, and institutional practice. *Although cIMT shows a significant potential to be implemented in clinical practice, further evidence is needed before such implementation can occur and further studies are needed to elaborate on the ability of this marker to reclassify, discriminate, and calibrate the risk of ED patients. ^¶CACS has a potent predictive ability recently shown; however, exposure to radiation should be carefully weighed. §Where appropriate. ABI: ankle-brachial index; CACS: coronary artery calcium scoring; CAD: coronary artery disease; CCTA: coronary computed tomography angiography; cIMT: carotid intima-media thickness; CVD: cardiovascular disease; ED: erectile dysfunction; PDE5i: phosphodiesterase type 5 inhibitors; PWV: pulse wave velocity; TRT: testosterone replacement therapy.