title: Asymmetric dimethylarginine is an independent risk factor for coronary heart disease: results from the multicenter Coronary Artery Risk Determination investigating the Influence of ADMA Concentration (CARDIAC) study.
abstract: BACKGROUND
  Asymmetric dimethylarginine (ADMA) plasma levels have been shown to be elevated in diseases related to endothelial dysfunction such as hypertension, hyperlipidemia, diabetes mellitus, and others. It has been shown that ADMA predicts cardiovascular mortality in patients who have coronary heart disease (CHD). However, the question whether ADMA is an independent risk factor for CHD still remains unresolved.
  
  
  METHODS
  The CARDIAC study is a multicenter case-control study, designed to detect differences in ADMA plasma levels between patients with CHD and controls from the general population. We included in our analysis 131 cases and 131 controls, matched for age, sex, and body mass index.
  
  
  RESULTS
  We found that cases had higher ADMA plasma levels than controls (0.70 micromol/L [0.59-0.87 micromol/L] vs 0.60 micromol/L [0.54-0.69 micromol/L], P < .001). To evaluate the predictive power of ADMA regarding CHD, we calculated 2 multivariate logistic regression models including laboratory parameters and traditional risk factors. The odds ratio for ADMA in the multivariate model including the laboratory characteristics was 2.59 (1.61-4.17; P < .001); the odds ratio for the multivariate model including other risk factors was 6.04 (2.56-14.25; P < .001) for the third tertile (>0.72 micromol/L) versus the first (<0.58 micromol/L).
  
  
  CONCLUSIONS
  We conclude from the results of our study that ADMA is an independent risk factor for CHD.
authors.affiliation: Clinical Pharmacology Unit, Institute of Experimental and Clinical Pharmacology, Center of Experimental Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany. f.schulze@uke.uni-hamburg.de
authors.forename: Friedrich
authors.initials: F
authors.lastname: Schulze
authors.forename: Henrike
authors.initials: H
authors.lastname: Lenzen
authors.forename: Christoph
authors.initials: C
authors.lastname: Hanefeld
authors.forename: Asja
authors.initials: A
authors.lastname: Bartling
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Osterziel
authors.forename: Lilia
authors.initials: L
authors.lastname: Goudeva
authors.forename: Caroline
authors.initials: C
authors.lastname: Schmidt-Lucke
authors.forename: Magda
authors.initials: M
authors.lastname: Kusus
authors.forename: Renke
authors.initials: R
authors.lastname: Maas
authors.forename: Edzard
authors.initials: E
authors.lastname: Schwedhelm
authors.forename: Dietrich
authors.initials: D
authors.lastname: Strödter
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Simon
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Harald
authors.initials: H
authors.lastname: Tillmanns
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
authors.forename: Thomas
authors.initials: T
authors.lastname: Streichert
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Böger
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine