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Asymmetric Dimethylarginine Predicts One-year Recurrent Cardiovascular Events: Potential Biomarker of "Toxin
Hao Xu1, Zhuo Chen1, Qing-Hua Shang1
1Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
Insights
Serum levels of asymmetric dimethylarginine (ADMA) can predict recurrent cardiovascular events in patients with stable coronary heart disease (CHD). Higher ADMA levels indicate a greater risk, suggesting its potential as a biomarker for "toxin syndrome" in CHD.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Clinical Chemistry
Background:
- Coronary heart disease (CHD) poses significant risks for recurrent cardiovascular events (RCE).
- Identifying reliable prognostic biomarkers for RCE in stable CHD patients is crucial for risk stratification and management.
Purpose of the Study:
- To evaluate the prognostic significance of serum asymmetric dimethylarginine (ADMA) levels in patients with stable CHD.
- To explore ADMA as a potential biomarker for "toxin syndrome" in the context of CHD.
Main Methods:
- A prospective nested case-control study involving 1,503 Chinese patients with stable CHD.
- Serum ADMA levels were measured at baseline and compared between 36 patients who experienced RCE (cases) and 36 matched controls within a 1-year follow-up period.
Main Results:
- Higher serum ADMA levels were significantly associated with an increased risk of RCE in crude, case-mix, and multivariable models.
- The combined model of ADMA and high-sensitivity C-reactive protein (hsCRP) demonstrated superior predictive power for RCE compared to either biomarker alone.
Conclusions:
- Serum ADMA level is a potential prognostic biomarker for predicting 1-year RCE in patients with stable CHD.
- ADMA may serve as a biomarker for "toxin syndrome" in CHD, warranting further investigation.
Objective:
To examine the prognostic value of serum levels of asymmetric dimethylarginine (ADMA) in patients with stable coronary heart disease (CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.
Methods:
In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event (RCE) during 1-year follow-up. Serum levels of ADMA at the start of follow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction.
Results:
Based on the crude model, subjects in the 2 highest ADMA quartiles showed significantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio (OR) 4.09, 95% confidence interval (CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model (OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model (OR 6.64, 95% CI 1.40 to 31.49: OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein (hsCRP) showed better predictive power with areas under the receiver operator characteristic curves (0.779) than the model of either ADMA (0.694) or hsCRP (0.636).
Conclusion:
Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is ChiCTR-PRNRC-07000012].