title: Elevation of asymmetric dimethylarginine in patients with unstable angina and recurrent cardiovascular events.
abstract: OBJECTIVE
  We investigated the role of asymmetric dimethylarginine (ADMA) for clinical outcome of patients with unstable angina.
  
  
  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 micromol/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 micromol/L; P=0.01). There was a significant reduction of ADMA levels at 6 weeks after percutaneous coronary intervention (PCI) in patients with unstable angina who experienced no recurrent cardiovascular event (from 0.81+/-0.14 to 0.73+/-0.19 micromol/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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Experimental and Clinical Pharmacology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. t.krempl@uke.uni-harburg.de
authors.forename: Tanja K
authors.initials: TK
authors.lastname: Krempl
authors.forename: Renke
authors.initials: R
authors.lastname: Maas
authors.forename: Karsten
authors.initials: K
authors.lastname: Sydow
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Böger
authors.forename: Jan
authors.initials: J
authors.lastname: Kähler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood*; D000789:Angina, Unstable / Q000097:blood; D001120:Arginine / Q000031:analogs & derivatives* / Q000378:metabolism; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
chemical_list: C487735:dimethylarginine; D001120:Arginine