Phosphodiesterase-5 inhibitors (PDE5i) have been found to reduce the risk of major adverse cardiovascular events in men with both coronary artery disease (CAD) and erectile dysfunction (ED), with tadalafil showing greater cardiac benefits compared to sildenafil, according to a study presented at the American Urological Association’s annual meeting. The retrospective study analyzed over 41,000 men with CAD and ED and found that those who took tadalafil or sildenafil had significantly lower 5-year risks of heart failure, myocardial infarction, and overall mortality compared to those who received no PDE5i treatment. Tadalafil recipients had even lower risks than sildenafil recipients across all categories. The study suggests that understanding the specific differences among PDE5i medications is crucial for addressing cardiac outcomes in patients with ED and CAD, with tadalafil potentially offering superior benefits due to differences in pharmacokinetics and longer duration of efficacy. However, further research is needed before definitive conclusions can be made regarding preferential prescription of tadalafil over other PDE5i medications.