European Heart Journal Advance Access originally published online on April 28, 2005
European Heart Journal 2005 26(18):1846-1851; doi:10.1093/eurheartj/ehi287
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Elevation of asymmetric dimethylarginine in patients with unstable angina and recurrent cardiovascular events
1Institute of Experimental and Clinical Pharmacology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
2Department of Cardiology and Angiology, Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
3Vascular Medicine and Biology, Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
Received 14 September 2004; revised 21 January 2005; accepted 24 March 2005; online publish-ahead-of-print 28 April 2005.
* Corresponding author. E-mail address: t.krempl{at}uke.uni-hamburg.de
Aims We investigated the role of asymmetric dimethylarginine (ADMA) for clinical outcome of patients with unstable angina.
Methods and results Forty-five patients with stable angina, 36 patients with unstable angina, and 40 healthy controls were included in this study. Coronary artery disease (CAD) patients were prospectively followed for 1 year. ADMA levels were measured at baseline and after 6 weeks using a validated ELISA. Baseline ADMA concentration in controls was significantly lower than in patients with CAD (0.59±0.23 vs. 0.76±0.17 µmol/L; P<0.001). Patients with unstable angina had significantly higher baseline ADMA levels than patients with stable angina (0.82±0.18 vs. 0.73±0.15 µmol/L; P=0.01). There was a significant reduction of ADMA levels at 6 weeks after percutanous coronary intervention (PCI) in patients with unstable angina who experienced no recurrent cardiovascular event (from 0.81±0.14 to 0.73±0.19 µmol/L; P<0.05). In contrast, patients with unstable angina who had an event showed no significant decrease in ADMA at 6 weeks. Actuarial survival analysis showed a significantly higher event rate in patients with persistently elevated ADMA plasma concentrations.
Conclusion ADMA is significantly elevated in patients with unstable angina. A reduced ADMA level at 6 weeks after PCI may indicate a decreased risk of recurrent cardiovascular events.
Key Words: Asymmetric dimethylarginine • Nitric oxide • Coronary artery disease
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