Asymmetric Dimethylarginine versus Proton Pump Inhibitors Usage in Patients with Stable Coronary Artery Disease: A Cross-Sectional Study.
A recent experimental study suggested that proton pump inhibitors (PPI), widely used to prevent gastroduodenal complications of dual antiplatelet therapy, may increase the accumulation of the endogenous nitric oxide synthesis antagonist asymmetric dimethylarginine (ADMA), an adverse outcome predictor. Our aim was to assess the effect of PPI usage on circulating ADMA in coronary artery disease (CAD). Plasma ADMA levels were compared according to PPI use for ≥1 month prior to admission in 128 previously described non-diabetic men with stable CAD who were free of heart failure or other coexistent diseases. Patients on PPI tended to be older and with insignificantly lower estimated glomerular filtration rate (GFR). PPI use was not associated with any effect on plasma ADMA (0.51 ± 0.11 (SD) vs. 0.50 ± 0.10 µmol/L for those with PPI (n = 53) and without PPI (n = 75), respectively; p = 0.7). Additionally, plasma ADMA did not differ between PPI users and non-users stratified by a history of current smoking, CAD severity or extent. The adjustment for patients' age and GFR did not substantially change the results. Thus, PPI usage does not appear to affect circulating ADMA in non-diabetic men with stable CAD. Whether novel mechanisms of adverse PPI effects on the vasculature can be translated into clinical conditions, requires further studies.
Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College and John Paul II Hospital, 80 Prądnicka, 31-202 Cracow, Poland. olga.kruszelnicka@onet.pl.
Olga
O
Kruszelnicka
Second Department of Cardiology, Jagiellonian University Medical College and University Hospital, 17 Kopernika, 31-501 Cracow, Poland. grasshoppers@interia.eu.
Jolanta
J
Świerszcz
Department of Electrocardiology, John Paul II Hospital, 80 Prądnicka, 31-202 Cracow, Poland. bednareks@op.pl.
Jacek
J
Bednarek
Second Department of Cardiology, Jagiellonian University Medical College and University Hospital, 17 Kopernika, 31-501 Cracow, Poland. chyrchelb@gmail.com.
Bernadeta
B
Chyrchel
Second Department of Cardiology, Jagiellonian University Medical College and University Hospital, 17 Kopernika, 31-501 Cracow, Poland. surdacki.andreas@gmx.net.
Andrzej
A
Surdacki
Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College and John Paul II Hospital, 80 Prądnicka, 31-202 Cracow, Poland. jnessler@interia.pl.
Jadwiga
J
Nessler
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000009:adverse effects; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000009:adverse effects; D000077402:Pantoprazole; D010437:Peptic Ulcer / Q000517:prevention & control*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; C018524:N,N-dimethylarginine; D001120:Arginine; D000077402:Pantoprazole; D009853:Omeprazole
asymmetric dimethylarginine; coronary artery disease; proton pump inhibitors