title: Asymmetric dimethylarginine independently predicts fatal and nonfatal myocardial infarction and stroke in women: 24-year follow-up of the population study of women in Gothenburg.
abstract: OBJECTIVE
  Asymmetrical dimethylarginine (ADMA) reduces nitric oxide by inhibiting nitric oxide synthase is associated with cardiovascular disease (CVD). Our study examined the association of ADMA with CVD prospectively in a healthy population-based cohort of women.
  
  
  RESULTS
  We measured baseline ADMA of 880 women in the Population Study of Women in Gothenburg using high-performance liquid chromatography. After adjustment for traditional risk factors, creatinine clearance, and homocysteine using Cox models, the HR (95% CI in parentheses) of CVD end points at 24 years for a 0.15 micromol/L (1 SD) increase in ADMA were: all-cause mortality 1.12 (0.96, 1.32), fatal CVD 1.30 (1.04, 1.62), total CVD events 1.29 (1.09, 1.53). The top quintile (ADMA >or=0.71 micromol/L) compared with the bottom four-fifths, conferred a cumulative risk 22 versus 14%, relative risk 1.75 (95% CI 1.18, 2.59) and population attributable risk 12.7% of total CVD events, and further identified individuals who are at higher than expected risk based on the SCORE and Framingham systems.
  
  
  CONCLUSIONS
  A 0.15 mumol/L increase in baseline ADMA levels is associated with approximately 30% increase in incident cardiovascular risk at 24 years in women after adjustment. ADMA levels >or=0.71 micromol/L enhances CVD risk assessment in women.
authors.affiliation: Department of Cardiology, Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland.
authors.forename: Tora
authors.initials: T
authors.lastname: Leong
authors.forename: Dimitri
authors.initials: D
authors.lastname: Zylberstein
authors.forename: Ian
authors.initials: I
authors.lastname: Graham
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.forename: Deirdre
authors.initials: D
authors.lastname: Ward
authors.forename: Jane
authors.initials: J
authors.lastname: Fogarty
authors.forename: Calle
authors.initials: C
authors.lastname: Bengtsson
authors.forename: Cecilia
authors.initials: C
authors.lastname: Björkelund
authors.forename: Dag
authors.initials: D
authors.lastname: Thelle
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D013548:Sweden
chemical_list: D015415:Biomarkers; D006710:Homocysteine; C018524:N,N-dimethylarginine; D001120:Arginine