Copyright © 2003 by the European Society of Cardiology.
Clinical research
Plasma levels of asymmetrical dimethylarginine and adverse cardiovascular events after percutaneous coronary intervention1
a Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
* Corresponding author. Yu-An Ding, Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan, Republic of China. Tel.: +886-2-2875-7229; fax: +886-2-2875-3580
E-mail address: yading{at}vghtpe.gov.tw
Received 30 March 2003; revised 30 July 2003; accepted 21 August 2003
Abstract
Aims We investigated the predictive value of plasma concentration of asymmetrical dimethylarginine (ADMA) on clinical outcome in patients undergoing percutaneous coronary intervention (PCI).
Methods and results One-hundred and fifty-three consecutive patients with stable angina and undergoing PCI were prospectively enrolled for clinical follow-up. Plasma ADMA levels were determined before procedure by high performance liquid chromatography. The major adverse cardiovascular events included cardiovascular death, myocardial infarction, and repeat revascularization of target vessels. Patients were grouped into tertiles according to their plasma ADMA levels. Over a follow-up period of 16 months (median), cardiovascular events occurred in 6 patients of tertile I (<0.50µM), in 17 patients of tertile II (0.50–0.62µM), and in 28 patients of tertile III (>0.62µM), P<0.001. By multivariate analysis, tertiles of ADMA levels were independently associated with a higher risk of adverse cardiovascular events after PCI (relative risk: tertile II vs I: 3.0 [1.2–7.7], P=0.022; tertile III vs I: 5.3 [2.2–12.9], P<0.001). Moreover, plasma ADMA level in the highest tertile also appeared as a significant risk factor of subsequent death and non-fatal myocardial infarction after PCI (tertile III vs I, P=0.04).
Conclusion Pre-procedural plasma ADMA levels may independently predict subsequent adverse cardiovascular events in patients undergoing PCI. Measurement of plasma ADMA levels could provide a rationale for risk stratification of patients by measuring ADMA levels before intervention.
Key Words: Asymmetrical dimethylarginine • Nitric oxide • Percutaneous coronaryintervention
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