Plasma levels of asymmetrical dimethylarginine and adverse cardiovascular events after percutaneous coronary intervention.
OBJECTIVE
We investigated the predictive value of plasma concentration of asymmetrical dimethylarginine (ADMA) on clinical outcome in patients undergoing percutaneous coronary intervention (PCI).


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 (<0.50microM), in 17 patients of tertile II (0.50-0.62microM), and in 28 patients of tertile III (>0.62microM), 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).


CONCLUSIONS
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.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming University, Taiwan, Taipei, Republic of China.
Tse-Min
TM
Lu
Yu-An
YA
Ding
Shing-Jong
SJ
Lin
Wen-Shin
WS
Lee
Ho-Charng
HC
Tai
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003327:Coronary Disease / Q000097:blood* / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors*; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine; D019001:Nitric Oxide Synthase