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Elevated plasma dimethylglycine is a risk marker of mortality in patients with coronary heart disease
Gard F T Svingen1, Hall Schartum-Hansen2, Per M Ueland3
1Department of Clinical Science, University of Bergen, Norway gard.frodahl.svingen@helse-bergen.no.
Insights
Elevated plasma dimethylglycine levels are linked to increased mortality risk in coronary heart disease (CHD) patients. This biomarker also enhances the prediction of cardiovascular death, offering valuable insights for risk assessment.
Area of Science:
- Cardiovascular Medicine
- Biomarker Research
- Clinical Epidemiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Accurate risk prediction is crucial for effective patient management and preventative strategies.
- Identifying novel biomarkers for CHD mortality risk is an ongoing area of research.
Purpose of the Study:
- To determine the association between plasma dimethylglycine levels and mortality in patients with coronary heart disease (CHD).
- To evaluate the potential of plasma dimethylglycine in improving the risk prediction of mortality among CHD patients.
Main Methods:
- Utilized Cox regression modeling to analyze data from two independent cohorts: suspected stable angina pectoris (SAP) and acute myocardial infarction (AMI).
- Investigated the association between plasma dimethylglycine levels and all-cause, cardiovascular, and non-cardiovascular mortality.
- Assessed the incremental predictive value of plasma dimethylglycine when added to established CHD risk factors.
Main Results:
- Elevated plasma dimethylglycine showed a linear association with increased all-cause mortality risk in both SAP and AMI cohorts.
- The association was stronger for cardiovascular mortality compared to non-cardiovascular mortality.
- Plasma dimethylglycine improved risk prediction for all-cause and cardiovascular mortality, particularly in AMI patients, even after adjusting for traditional risk factors.
Conclusions:
- Higher plasma dimethylglycine levels are significantly associated with increased mortality risk in patients with suspected or confirmed CHD.
- Plasma dimethylglycine serves as a valuable biomarker for enhancing the prediction of mortality, especially cardiovascular death, in CHD patients.
Aim:
To investigate whether plasma dimethylglycine was associated with and improved risk prediction of mortality among patients with coronary heart disease (CHD).
Methods:
By Cox modelling, we explored the association between plasma dimethylglycine and mortality in two independent cohorts of patients with suspected stable angina pectoris (SAP) (n = 4156) and acute myocardial infarction (AMI) (n = 3733). We also assessed any improvement in risk prediction by adding plasma dimethylglycine to established CHD risk factors.
Results:
Median follow-up time was 4.7 and 7.0 years among patients with SAP and AMI, respectively. Across both cohorts, elevated plasma dimethylglycine levels were linearly associated with increased risk of all-cause mortality (age and gender adjusted hazard ratios (95% confidence interval, CI) were 1.72 (1.21-2.46) and 1.76 (1.42-2.18) when comparing the fourth versus the first plasma dimethylglycine quartile in patients with SAP and AMI, respectively). There was a particularly strong risk association between plasma dimethylglycine and cardiovascular, as compared with non-cardiovascular, mortality (age and gender adjusted hazard ratios (95% CI) 1.94 (1.21-3.11) and 1.43 (0.83-2.47) among patients with SAP and 1.97 (1.50-2.59) and 1.44 (1.02-2.04) among patients with AMI, respectively). The relationship between dimethylglycine and all-cause and cardiovascular mortality was only slightly attenuated in analyses adjusted for established CHD risk factors. Plasma dimethylglycine also improved risk prediction for all-cause and cardiovascular mortality, and especially among patients with AMI.
Conclusions:
Elevated plasma dimethylglycine was associated with and improved risk prediction of mortality in patients with suspected or verified CHD. This relationship was stronger for death from cardiovascular, as compared with non-cardiovascular, causes.
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