Asymmetrical dimethylarginine - a new way of assessing cardiovascular risk?

December 20, 2001

N.B Please note that if you are outside North America the embargo date for Lancet Press Material is 0001 hours UK time Friday 21st December 2001.

Authors of a study in this week's issue of THE LANCET conclude that increased concentrations of the naturally occuring organic compound asymmetrical dimethylarginine (ADMA) is a strong predictor of death and cardiovascular disease in haemodialysis patients. A research letter also published this week suggests that increased concentrations of ADMA may indicate a cardiovascular risk in men with normal kidney function.

The plasma concentration of ADMA, which has been linked to endothelial dysfunction and atherosclerosis in the general population, is raised in patients with end-stage renal disease and could contribute to the high cardiovascular risk in patients with chronic renal failure. Rainer Böger from University Hospital Hamburg-Eppendorf, Germany, and colleagues investigated the relation between cardiovascular risk factors and plasma ADMA concentration in 225 haemodialysis patients, and tested the predictive power of ADMA for death and cardiovascular outcomes.

Patients had standard dialysis three times a week. Cardiovascular events were recorded over an average follow-up of 33 months. ADMA concentration in plasma was directly related to concentrations of fibrinogen and L-arginine in plasma, duration of dialysis treatment, and serum cholesterol concentration. 83 patients died, 53 (64%) from cardiovascular causes. Concentrations of plasma ADMA ranked as the second most important factor (after age) predicting overall death and cardiovascular events.

In a research letter (p 2127), Reijo Laaksonen and colleagues from the University of Helsinki, Finland, report that middle-aged men (with normal kidney function) from eastern Finland who were in the top quartile for ADMA concentration were four times more likely of having acute coronary events than men with lower ADMA concentrations.

In an accompanying Commentary (p 2096), Patrick Vallance from University College London, UK, concludes: "...The finding that ADMA predicts outcome in patients with renal disease may be of direct and practical clinical relevance." Referring to the Finnish study, he adds: "Since renal function in this group was not impaired and thus, excretion of ADMA presumably was normal, DDAH [the enzyme dimethylarginine dimethylaminohydrolase] dysfunction is strongly implicated as a primary mechanism. It will now be interesting to examine whether ADMA is also a predictor of event rates in other cardiovascular disorders in which it accumulates, and whether DDAH dysfunction produces an adverse metabolic change equivalent to renal failure in individual cells and tissues."
-end-
Contact: Dr Rainer H Böger, Clinical Pharmacology Unit, Department of Pharmacology, University Hospital Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany; T) +49 40 42 803 97 59; F) +49 40 42 803 97 57; E) boeger@uke.uni-hamburg.de

Dr Reijo Laaksonen, current address: Department of Neurology, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070 Brussels, Belgium; T) +32 2 555 3992; F) +32 2 555 3942; E) reijo.laaksonen@helsinki.fi

Dr Patrick Vallance, Centre for Clinical Pharmacology and Therapeutics, Department of Medicine, University College London, London WC1E 6JJ, UK; E) rmhapav@ucl.ac.uk

Lancet

Related Cardiovascular Disease Articles from Brightsurf:

Changes by income level in cardiovascular disease in US
Researchers examined changes in how common cardiovascular disease was in the highest-income earners compared with the rest of the population in the United States between 1999 and 2016.

Fighting cardiovascular disease with acne drug
Researchers from the European Molecular Biology Laboratory (EMBL) in Heidelberg and Stanford University have found the cause of dilated cardiomyopathy - a leading cause of heart failure - and identified a potential treatment for it: a drug already used to treat acne.

A talk with your GP may prevent cardiovascular disease
Having a general practitioner (GP) who is trained in motivational interviewing may reduce your risk of getting cardiovascular disease.

Dilemma of COVID-19, aging and cardiovascular disease
Whether individuals should continue to take angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the context of coronavirus disease 2019 (COVID-19) is discussed in this article.

Air pollution linked to dementia and cardiovascular disease
People continuously exposed to air pollution are at increased risk of dementia, especially if they also suffer from cardiovascular diseases, according to a study at Karolinska Institutet in Sweden published in the journal JAMA Neurology.

New insights into the effect of aging on cardiovascular disease
Aging adults are more likely to have - and die from - cardiovascular disease than their younger counterparts.

Premature death from cardiovascular disease
National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.

Ultrasound: The potential power for cardiovascular disease therapy
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Despite the ACA, millions of Americans with cardiovascular disease still can't get care
Cardiovascular disease (CVD) is the leading cause of death for Americans, yet millions with CVD or cardiovascular risk factors (CVRF) still can't access the care they need, even years after the implementation of the Affordable Care Act (ACA).

Excess weight and body fat cause cardiovascular disease
In the first Mendelian randomization study to look at this, researchers have found evidence that excess weight and body fat cause a range of heart and blood vessel diseases (rather than just being associated with it).

Read More: Cardiovascular Disease News and Cardiovascular Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.