title: Could plasma asymmetric dimethylarginine level be a novel predictor beyond the classic predictors of stent restenosis?
abstract: OBJECTIVE
  The aim of this study was to investigate the factors associated with coronary stent restenosis and if there is an association between plasma asymmetric dimethylarginine (ADMA) levels and stent restenosis.
  
  
  METHODS
  Ninety-one patients, who had a history of coronary bare metal stent implantation due to any cause in the last one year period, were admitted to this observational cross-sectional study. Coronary angiography was performed to all patients and quantitative angiography was used to determine the presence of stent restenosis. Laboratory parameters and angiographic features that contribute to stent restenosis were evaluated. Plasma ADMA levels were measured by using high performance liquid chromatography. Logistic regression analysis was used to determine the independent factors of stent restenosis.
  
  
  RESULTS
  Angiographic restenosis was found in 35 patients (38.5%). Stent diameter (p=0.038) and left ventricular ejection fraction (p=0.023) were lower and stent implantation history due to acute coronary syndrome (p=0.029), plasma ADMA level (5.0±1.8x10-4 mmol/L vs. 3.9±1.0x10-4 mmol/L, p=0.001), C-reactive protein concentration (p=0.016), white blood cell count (p=0.044) and stent length (p=0.005) were higher in patients with restenosis. Plasma ADMA level (β=0.536; OR: 1.710; CI: 1.022-2.861; p=0.041), C-reactive protein concentration (β=0.062; OR: 1.064; CI: 1.003-1.129; p=0.041), stent diameter (β=-3.047; OR: 0.048; CI: 0.007-0.313; p=0.002) and length (β=0.165; OR: 1.179; CI: 1.036-1.343; p=0.013) were found to be the independent predictors of stent restenosis in logistic regression analysis.
  
  
  CONCLUSIONS
  We conclude that plasma ADMA levels may be used as a novel marker for stent restenosis beyond the classic stent restenosis markers.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University; Ankara-Turkey. ugurabbasbal@yahoo.com.
authors.forename: Uğur Abbas
authors.initials: UA
authors.lastname: Bal
authors.forename: Aylin
authors.initials: A
authors.lastname: Yıldırır
authors.forename: Alp
authors.initials: A
authors.lastname: Aydinalp
authors.forename: Gamze
authors.initials: G
authors.lastname: Kaynar
authors.forename: Süleyman
authors.initials: S
authors.lastname: Kanyilmaz
authors.forename: Koza
authors.initials: K
authors.lastname: Murat
authors.forename: Ibrahim Haldun
authors.initials: IH
authors.lastname: Müderrisoğlu
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine