Author Affiliation: University of Queensland, Brisbane, Australia.
Sildenafil has been in widespread use for 3 years, but concerns persist
regarding its safety in patients with a history of cardiac disease. Major
adverse effects, including myocardial infarction and death, have been recorded
in case reports and postmarketing surveillance.1
However, questions have been raised regarding the accuracy of these reports,
the potential for reporting bias, and whether the number of reported events
exceeds that expected in a population of this age.2
The central issue is to what extent these adverse events reflect a risk from
the drug and to what extent they reflect the risks of physical activity in
patients with coronary artery disease.
Marwick TH. Safe Sex for Men With Coronary Artery DiseaseExercise, Sildenafil, and Risk of Cardiac Events. JAMA. 2002;287(6):766-767. doi:10.1001/jama.287.6.766