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.
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.
Schulze
Friedrich
F
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
Lenzen
Henrike
H
Hanefeld
Christoph
C
Bartling
Asja
A
Osterziel
Karl J
KJ
Goudeva
Lilia
L
Schmidt-Lucke
Caroline
C
Kusus
Magda
M
Maas
Renke
R
Schwedhelm
Edzard
E
Strödter
Dietrich
D
Simon
Bernd C
BC
Mügge
Andreas
A
Daniel
Werner G
WG
Tillmanns
Harald
H
Maisch
Bernhard
B
Streichert
Thomas
T
Böger
Rainer H
RH
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
C018524:N,N-dimethylarginine; D001120:Arginine