Plasma asymmetric dimethylarginine concentrations in newly diagnosed patients with acute myocardial infarction or unstable angina pectoris during two weeks of medical treatment.
A high concentration of plasma asymmetric dimethylarginine (ADMA) has been associated with several risk factors for atherosclerosis, and this may increase the risk for acute coronary syndromes (ACSs). We measured plasma ADMA concentrations in patients who had newly diagnosed ACS (n = 48), and we followed the changes in ADMA concentrations during these patients' short-term medical therapy, which included various combination of drugs with or without percutaneous coronary interventions according to the needs of each patient. Concentrations of plasma ADMA were found to be high in patients who had ACS compared with 48 age-matched healthy control subjects (3.13 +/- 0.85 vs 1.57 +/- 0.85 mumol/L, p <0.0001). Follow-up measurements of ADMA showed dramatic decreases in plasma ADMA concentrations over 2 weeks of medical therapy for ACS (from 3.27 +/- 0.87 to 1.52 +/- 0.47 mumol/L, p <0.0001). Plasma ADMA at baseline showed a significant positive correlation with serum C-reactive protein and plasma insulin and a significant negative correlation with serum levels of high-density lipoprotein and plasma alpha-tocopherol. During therapy, changes in plasma ADMA concentrations were significantly correlated with changes in the ratio of total cholesterol to high-density lipoprotein cholesterol and in serum C-reactive protein concentrations but not with changes in insulin levels. This study provides the first evidence that plasma ADMA concentrations are significantly high in patients who have ACS and that ADMA concentrations rapidly decrease after short-term medical therapy.
Bae
Sung Won
SW
Division of Cardiology, Samsung Medical Center & Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Stühlinger
Markus C
MC
Yoo
Hwan Soo
HS
Yu
Kyung Hyun
KH
Park
Haing Kee
HK
Choi
Bo Yoon
BY
Lee
Yun-Sun
YS
Pachinger
Otmar
O
Choi
Yoon-Ho
YH
Lee
Sang Hoon
SH
Park
Jeong Euy
JE
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D004791:Enzyme Inhibitors / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D013223:Statistics as Topic; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
D002317:Cardiovascular Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004791:Enzyme Inhibitors; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine; D002784:Cholesterol; D024502:alpha-Tocopherol