Abstract 462: Effect of Coronary Revascularization on Plasma Level of Asymmetric Dimethylarginine
Background: Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase. Increased ADMA plasma levels are associated with atherosclerosis and cardiovascular disease. In this study we investigated the plasma levels of ADMA in patients who underwent different type of coronary revascularization.
Methods: Concentrations of ADMA, l-arginine, symmetric dimethylarginine (SDMA) were measured by liquid chromatography-tandem mass spectrometry in four groups: group I consisted of 16 patients with ST-elevation myocardial infarction (STEMI), and group II included 24 patients who underwent elective percutaneous coronary intervention (PCI). Before PCI and at 1 hour, 5 days and 30 days after reperfusion blood samples were taken for measurement of l-arginine, ADMA and SDMA. Group III consisted of 21 patients undergoing off-pump and group IV included 20 patients undergoing on-pump coronary artery bypass graft (CABG) surgery. The measurements were performed 24 h before, 3 times during the operation (via coronary sinus catheter), and on the 1st and 5th postoperative day.
Results: In patients with elective stent implantation stenting induced a prompt and sustained depression of ADMA (F=9.594, p<0.001), however ADMA remained constant for STEMI patients after stent placement (F=2.982, p=0.069). The differences in the time-course for ADMA (F=9.431, p<0.001) proved to be significant between the two groups. We did not find significant change in the plasma concentration of ADMA during off-pump CABG surgery (F=0.416, p=0.68), however ADMA concentration increased significantly in patients who underwent on-pump surgery both in the coronary sinus (F=14.751, p<0.001) and peripheral blood (F=30.738, p<0.001). Therefore, the intersubject time effect, was significant (F=6.990, p=0.002).
Conclusions: The main finding of the present study is that the response pattern of the new cardiovascular risk factor, ADMA was significantly different between the two PCI and the CABG groups. Its long-term follow-up may be suitable to monitor the improvement of coronary function after revascularisation. This method should be feasible to monitor of the ADMA metabolism during coronary revascularization.
Author Disclosures: A. Nemeth: None. Z. Lenkey: None. Z. Ajtay: None. A. Cziraki: None. E. Sulyok: None. I. Horvath: None. B. Nemeth: None. S. Szabados: None. A. Nasri: None. J. Lobenhoffer: None. S. Bode-Böger: None.
- © 2014 by American Heart Association, Inc.