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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Vydáno v:Arteriosclerosis, thrombosis, and vascular biology Ročník 28; číslo 5; s. 954
Hlavní autoři: 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
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.05.2008
Témata:
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
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Abstract 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.
AbstractList 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.OBJECTIVEAsymmetrical 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.METHODS AND RESULTSBlood 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.CONCLUSIONSOur study suggests that the baseline ADMA level has a strong prognostic value for mortality after MI, beyond traditional risk factors and biomarkers.
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.
Author Lagrost, Anne-Cécile
Korandji, Claudia
Gambert, Philippe
Guilland, Jean-Claude
Duvillard, Laurence
Beer, Jean-Claude
Cottin, Yves
Lorgis, Luc
Rochette, Luc
Sicard, Pierre
Vergely, Catherine
Moreau, Daniel
Zeller, Marianne
Author_xml – sequence: 1
  givenname: Marianne
  surname: Zeller
  fullname: Zeller, Marianne
  email: marianne.zeller@u-bourgogne.fr
  organization: Laboratory of Experimental Cardiovascular Pathophysiology and Pharmacology, Faculty of Medicine, University of Burgundy, Dijon Cedex, France. marianne.zeller@u-bourgogne.fr
– sequence: 2
  givenname: Claudia
  surname: Korandji
  fullname: Korandji, Claudia
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  givenname: Jean-Claude
  surname: Guilland
  fullname: Guilland, Jean-Claude
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  surname: Sicard
  fullname: Sicard, Pierre
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  fullname: Lagrost, Anne-Cécile
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  surname: Moreau
  fullname: Moreau, Daniel
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  givenname: Philippe
  surname: Gambert
  fullname: Gambert, Philippe
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  givenname: Yves
  surname: Cottin
  fullname: Cottin, Yves
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  givenname: Luc
  surname: Rochette
  fullname: Rochette, Luc
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Snippet Asymmetrical dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthases. From a prospective cohort of patients with acute...
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SubjectTerms 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
Title Impact of asymmetric dimethylarginine on mortality after acute myocardial infarction
URI https://www.ncbi.nlm.nih.gov/pubmed/18276906
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