title: Relationship of asymmetric dimethylarginine (ADMA) with extent and functional severity of coronary atherosclerosis.
abstract: BACKGROUND
  Elevated serum levels of asymmetric dimethylarginine (ADMA) are associated with endothelial dysfunction and atherogenesis. In patients with suspected coronary artery disease (CAD), we assessed the correlation of serum ADMA levels with extent and functional significance of coronary atherosclerosis.
  
  
  METHODS
  We enrolled 281 patients with suspected CAD undergoing coronary angiogram. Angiographic CAD severity was evaluated by Bogaty score. In patients with angiographic evidence of at least one intermediate coronary stenosis (≥50% diameter stenosis), functional significance was assessed by fractional flow reserve (FFR). Blood samples were collected in all patients prior to coronary angiography for measurement of serum ADMA levels.
  
  
  RESULTS
  We observed across tertiles of ADMA levels increasingly higher values of both Stenosis Score (2.25±1.70 vs. 2.89±1.99 vs. 2.95±1.82, p=0.016) and Extent Index (0.52±0.32 vs. 0.61±0.39 vs. 0.72±0.47, p=0.003). The association between ADMA levels and Extent Index remained significant after multivariate adjustment (p=0.005). Patients with FFR ≤0.80 in at least one vessel (n=113) had significantly higher ADMA levels compared with patients without functionally significant CAD (0.51 [0.43-0.64] vs. 0.46 [0.39-0.58]μmol/L, p=0.005). Serum ADMA levels were independent predictors of abnormal FFR after adjustment for extent score (odds ratio 7.35, 95% confidence interval 1.05-56.76, p=0.046).
  
  
  CONCLUSIONS
  Serum ADMA levels are independent predictors of coronary atherosclerosis extent and functional significance of CAD.
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mangiacapra
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Micaela
authors.initials: M
authors.lastname: Conte
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Demartini
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Muller
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Delrue
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Karen
authors.initials: K
authors.lastname: Dierickx
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: De Bruyne
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: Bartunek
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. Electronic address: emanuele.barbato@olvz-aalst.be.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine
keywords: Asymmetric dimethylarginine; Coronary atherosclerosis; Fractional flow reserve