Asymmetric Dimethylarginine and the Risk of Cardiovascular Events and Death in Patients With Coronary Artery Disease
Why the study?
Does baseline ADMA level predict cardiovascular events and death in patients with coronary artery disease?
Population
1874 consecutive patients with coronary artery disease
Comparison
High baseline serum concentration of asymmetric… vs Low baseline serum concentration of ADMA
Design
Cohort
Follow-up
mean 2.6+/-1.2 years
Authors
Discussion
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Implication
May refine risk stratification in CAD; extends biomarker data but leaves open therapeutic targeting.
Key Points
- To assess the prognostic value of baseline serum asymmetric dimethylarginine (ADMA) levels for predicting cardiovascular events and death in patients with coronary artery disease.
- Prospective cohort study evaluating baseline serum ADMA concentrations in 1874 consecutive patients with coronary artery disease.
- Patients were monitored over a mean follow-up period of 2.6 ± 1.2 years for the primary endpoint of cardiovascular death or nonfatal myocardial infarction.
- The primary endpoint occurred in 114 patients, who demonstrated significantly higher median baseline ADMA levels than event-free patients (0.70 vs 0.63 µmol/L; P < 0.001).
- Patients in the highest tertile of baseline ADMA had a greater risk of adverse events than those in the lowest tertile (hazard ratio [HR], 2.48; 95% CI, 1.52 to 4.06; P < 0.001; P for trend < 0.001).
- In multivariable models adjusting for traditional risk factors and other biomarkers, ADMA remained an independent predictor of cardiovascular risk (HR, 1.90; 95% CI, 1.3 to 2.8; P = 0.001).
Structured PICO
Does baseline ADMA level predict cardiovascular events and death in patients with coronary artery disease?
P
Population
1874 consecutive patients with coronary artery disease
I
Intervention
High baseline serum concentration of asymmetric dimethylarginine (ADMA) (highest third)
C
Comparator
Low baseline serum concentration of ADMA (lowest third)
O
Outcome
Composite of death from cardiovascular causes or nonfatal myocardial infarctioncomposite
High baseline ADMA levels independently predict future cardiovascular risk in patients with coronary artery disease, offering prognostic value beyond traditional risk factors.
Cite This Study
Schnabel et al. (2005) studied this question.