Impact of asymmetric dimethylarginine on mortality after acute myocardial infarction

Asymmetrical dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthases. From a prospective cohort of patients with acute myocardial infarction (MI), we aimed to analyze the predictive value of circulating ADMA concentrations on prognosis. Blood samples from 249 co...

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Published in:Arteriosclerosis, thrombosis, and vascular biology Vol. 28; no. 5; p. 954
Main Authors: Zeller, Marianne, Korandji, Claudia, Guilland, Jean-Claude, Sicard, Pierre, Vergely, Catherine, Lorgis, Luc, Beer, Jean-Claude, Duvillard, Laurence, Lagrost, Anne-Cécile, Moreau, Daniel, Gambert, Philippe, Cottin, Yves, Rochette, Luc
Format: Journal Article
Language:English
Published: United States 01.05.2008
Subjects:
Aged
Aged, 80 and over
Arginine - analogs & derivatives
Arginine - blood
Biomarkers - blood
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - mortality
Predictive Value of Tests
Prognosis
Prospective Studies
Regression Analysis
ISSN:1524-4636, 1524-4636
Online Access:Get more information
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Summary:Asymmetrical dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthases. From a prospective cohort of patients with acute myocardial infarction (MI), we aimed to analyze the predictive value of circulating ADMA concentrations on prognosis. Blood samples from 249 consecutive patients hospitalized for acute MI <24 hours were taken on admission. Serum levels of ADMA and its stereoisomer, symmetrical dimethylarginine (SDMA), were determined using high-performance liquid chromatography. The independent predictors of ADMA were glomerular filtration rate, female sex, and SDMA (R(2)=0. 25). Baseline ADMA levels were higher in patients who had died than in patients who were alive at 1 year follow-up (1.23 [0.98 to 1.56] versus 0.95 [0.77 to 1.20] micromol/L, P<0.001). By Cox multivariate analysis, the higher tertile of ADMA (median [interquartile range]: 1.45 [1.24 to 1.70] micromol/L) was a predictor for mortality (Hazard Ratio [95% CI], 4.83 [1.59 to 14.71]), when compared to lower tertiles, even when adjusted for potential confounders, such as acute therapy, biological, and clinical factors. Our study suggests that the baseline ADMA level has a strong prognostic value for mortality after MI, beyond traditional risk factors and biomarkers.
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ISSN:1524-4636
1524-4636
DOI:10.1161/ATVBAHA.108.162768