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Effect of Homoarginine on Coronary Artery Complexity and Atherosclerotic Burden in Patients with STEMI
Gülsüm Bingöl1,2, Ahmad Huraıbat3, Elif Ayduk Gövdeli4
1Department of Cardiology, Arel University Medicine Faculty, 34010 Istanbul, Turkey.
Insights
Low homoarginine levels predict complex coronary artery disease in ST-segment elevation myocardial infarction (STEMI) patients. This finding suggests homoarginine may be a key indicator of atherosclerotic burden.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Diagnostics
Background:
- Low circulating homoarginine is linked to cardiovascular disease and mortality risk.
- Reduced homoarginine levels are observed in patients with ischemic heart conditions.
- The SYNTAX score (SS) quantifies coronary artery disease (CAD) complexity.
Purpose of the Study:
- To investigate the association between homoarginine levels and CAD severity, as defined by the SYNTAX score.
- To evaluate homoarginine as a predictor of complex coronary artery disease in STEMI patients.
Main Methods:
- A cohort of 67 ST-segment elevation myocardial infarction (STEMI) patients undergoing coronary angiography was studied.
- Patients were stratified into low-medium (SS ≤ 14) and high (SS > 14) SYNTAX score groups.
- Serum homoarginine levels were measured and correlated with SYNTAX scores.
Main Results:
- Patients with high SYNTAX scores exhibited significantly lower serum homoarginine levels compared to those with low-medium scores (1.3 ± 0.7 vs. 2 ± 0.9, p=0.001).
- A significant negative correlation was found between homoarginine levels and SYNTAX score in the entire cohort.
- Multivariate analysis identified lower serum homoarginine as an independent predictor of higher SYNTAX scores (OR 1.073, p=0.049).
Conclusions:
- Diminished plasma homoarginine levels are an independent predictor of high atherosclerotic burden in STEMI patients.
- This study is the first to link homoarginine levels to coronary artery complexity in STEMI.
- Homoarginine may serve as a novel biomarker for assessing CAD severity.
Abstract:
Objective: Homoarginine is a cationic amino acid derived from lysine. Evidence indicates that low-circulating homoarginine concentration is a risk factor for cardiovascular disease and all-cause mortality. A reduction in homoarginine concentrations has been observed in patients with ischemic heart disease, ischemic stroke, ischemic heart disease, and heart failure. The SYNTAX score (SS), an angiographic scoring system, defines the grade and complexity of coronary artery disease (CAD). The objective of this study was to evaluate the relationship between homoarginine level and the severity of CAD according to the SYNTAX score in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 67 subjects were enrolled into the study with the diagnosis of STEMI of those who underwent coronary angiography. STEMI patients were divided into two groups: low-medium SYNTAX score ≤ 14 (35 patients) and high SYNTAX score > 14 (32 patients). Results: Within the high SS group, serum homoarginine levels were markedly lower (2 ± 0.9 vs. 1.3 ± 0.7; p = 0.001). Homoarginine levels and SS showed a significant negative correlation in entire study cohort In multivariate regression analysis, serum homoarginine levels along with serum urea levels were significantly associated with having higher SS (OR 1.073 p = 0.049 and OR 0.346, p = 0.012, respectively). Conclusions: In conclusion, the diminished plasma homoarginine level emerges as an independent predictor of high atherosclerotic burden among STEMI patients. To the best of our knowledge, this is the first study to demonstrate the relationship between homoarginine and coronary artery complexity.
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