Atrial Fibrillation Is Associated with a Marker of Endothelial Function and Oxidative Stress in Patients with Acute Myocardial Infarction

Atrial fibrillation (AF), whether silent or symptomatic, is a frequent and severe complication of acute myocardial infarction (AMI). Asymmetric dimethylarginine (ADMA), an endogenous eNOS inhibitor, is a risk factor for endothelial dysfunction. We addressed the relationship between ADMA plasma level...

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Published in:PloS one Vol. 10; no. 7; p. e0131439
Main Authors: Stamboul, Karim, Lorin, Julie, Lorgis, Luc, Guenancia, Charles, Beer, Jean-Claude, Touzery, Claude, Rochette, Luc, Vergely, Catherine, Cottin, Yves, Zeller, Marianne
Format: Journal Article
Language:English
Published: United States Public Library of Science 09.07.2015
Public Library of Science (PLoS)
Subjects:
Aged
Aged, 80 and over
Analysis
Arginine - analogs & derivatives
Arginine - blood
Atrial fibrillation
Atrial Fibrillation - physiopathology
Biomarkers - blood
Cardiac arrhythmia
Cardiac patients
Cardiology and cardiovascular system
Care and treatment
Chromatography
Chromatography, High Pressure Liquid
Electrocardiography
Endothelium
Endothelium - physiopathology
Female
Fibrillation
Heart attack
Heart rate
High performance liquid chromatography
Human health and pathology
Humans
Infarction
Kinases
Life Sciences
Liquid chromatography
Logistic Models
Male
Middle Aged
Mortality
Multivariate Analysis
Myocardial infarction
Myocardial Infarction - physiopathology
Nitric oxide
Observational studies
Oxidative Stress
Pathogenesis
Patients
Plasma levels
Regression analysis
Risk Assessment - methods
Risk Assessment - statistics & numerical data
Risk Factors
Rodents
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary:Atrial fibrillation (AF), whether silent or symptomatic, is a frequent and severe complication of acute myocardial infarction (AMI). Asymmetric dimethylarginine (ADMA), an endogenous eNOS inhibitor, is a risk factor for endothelial dysfunction. We addressed the relationship between ADMA plasma levels and AF occurrence in AMI. 273 patients hospitalized for AMI were included. Continuous electrocardiographic monitoring (CEM) ≥48 hours was recorded and ADMA was measured by High Performance Liquid Chromatography on admission blood sample. The incidence of silent and symptomatic AF was 39(14%) and 29 (11%), respectively. AF patients were markedly older than patients without AF (≈ 20 y). There was a trend towards higher ADMA levels in patients with symptomatic AF than in patients with silent AF or no AF (0.53 vs 0.49 and 0.49 μmol/L, respectively, p = 0.18,). After matching on age, we found that patients with symptomatic AF had a higher heart rate on admission and a higher rate of patients with LV dysfunction (28% vs. 3%, p = 0.025). Patients who developed symptomatic AF had a higher ADMA level than patients without AF (0.53 vs. 0.43 μmol/L; p = 0.001). Multivariate logistic regression analysis to estimate symptomatic AF occurrence showed that ADMA was independently associated with symptomatic AF (OR: 2.46 [1.21-5.00], p = 0.013) beyond history of AF, LVEF<40% and elevated HR. We show that high ADMA level is associated with the occurrence of AF. Although no causative role can be concluded from our observational study, our work further supports the hypothesis that endothelial dysfunction is involved in the pathogenesis of AF in AMI.
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PMCID: PMC4497674
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: KS JL LL CT MZ. Performed the experiments: KS YC MZ JCB. Analyzed the data: CT MZ. Contributed reagents/materials/analysis tools: CT MZ. Wrote the paper: YC LL CG LR CV.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0131439