Relationship between L-arginine/asymmetric dimethylarginine, homocysteine, folic acid, vitamin B levels, and coronary artery ectasia

BACKGROUND: Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. The ratio of L-arginine/asymmetric dimethylarginine (ADMA) and homocysteine are important factors for endothelial function. In this study, we investigate the ratio of L-arginine/ADMA, homocysteine, and folic acid/vitamin B levels in patients with CAE. METHODS: Forty patients diagnosed with CAE using coronary angiography were included in the study (24 male; mean age, 56 ± 11 years). The control group consisted of 30 patients who had normal coronary arteries as determined by coronary angiography (11 male; mean age, 54 ± 8 years). The ratio of L-arginine/ADMA and plasma homocysteine was measured using high-performance liquid chromatography. RESULTS: The L-arginine/ADMA ratio and L-arginine levels were significantly lower in the CAE group compared with the control group (110 ± 27 vs. 149 ± 77, P=0.02 and 157 ± 32 μmol/l vs. 187 ± 59 μmol/l, P=0.02, respectively). Plasma ADMA levels were similar in the two groups. Patients with CAE had higher plasma homocysteine levels (P=0.01). Plasma folic acid, vitamin B6, and vitamin B12 levels were similar between the two groups. CONCLUSION: This study shows that patients with CAE have a lower L-arginine/ADMA ratio and higher plasma homocysteine levels. These results show a potential relationship between endothelial dysfunction and CAE.