Elsevier

The Lancet

Volume 358, Issue 9299, 22–29 December 2001, Pages 2127-2128
The Lancet

Research Letters
Risk of acute coronary events and serum concentration of asymmetrical dimethylarginine

https://doi.org/10.1016/S0140-6736(01)07184-7Get rights and content

Summary

Asymmetrical dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor, which has been suggested to be a novel independent risk factor for endothelial dysfunction and coronary heart disease. We investigated the association of ADMA concentration in serum with risk of acute coronary events. We did a prospective, nested, case-control study in middle-aged men from eastern Finland. In an analysis of men who did not smoke, those who were in the highest quartile for ADMA (>0·62 μmol/L) had a 3·9-fold (95% CI 1·25–12·3, p=0·02) increase in risk of acute coronary events compared with the other quartiles. Our findings suggest that ADMA is a predictor of acute coronary events.

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    Nitric oxide synthase inhibition, another symptom of SDB, may also be partially responsible for downstream irregularities contributing to CVD and MDD pathogenesis. The nitric oxide synthesis inhibitors asymmetrical dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) have been linked to increased inflammation, endothelial damage, and acute coronary heart events [9,14–16]. ADMA and SDMA production also acts as a competing pathway for the conversion of L-arginine to nitric oxide (Fig. 1), contributing to the onset of depression through competitive inhibition that alters arginine bioavailability [17].

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