The Study Of Correlation Between Serum Asymmetric Dimethylarginine And Coronary Artery Disease

OBJECTIVE: With its prevalence increasing, coronary artery disease (CAD) has become the leading cardiovascular disease that impairs the quality of life. We have found several risk factors playing crucial roles in the pathogenesis of CAD, such as aging, hypercholesterolemia, hypertension,smoking and diabetes. However, certain groups of people with risk factors do not develop CAD ,and certain groups of people without risk factors do.So novel risk factors are expected to do something. Recently, asymmetric dimethylarginine(ADMA), an endogenous inhibitor of nitric oxide synthase(NOS), has come into the focus of cardiovascular research. ADMA is an analogue of L-arginine, and inhibits vascular nitric oxide (NO) production, contributing to the pathogenesis of endothelial dysfunction in atherosclerosis(AS). In several prospective and cross-sectional studies, ADMA evolved as a novel cardiovascular risk factor. And the correlation between ADMA and CAD is concerned.However there is few related studies reported in China. The present study was to investigate serum levels of ADMA in population of CAD as compared to healthy controls, furthermore to search the role of ADMA in AS and its probable clinical significance.METHODS: The study consisted of 51 CAD patients(age 52.44 ±11.47years,36 men)without statin treatment(CAD group), and 44 healthy individuals(age47.20±9.85 years ,30 men)(controls). Among the patients, 29 patients were applied for coronaryangiography. According to the result of angiography, the subjects were divided into two groups: mild and serious coronary artery disease.Total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides(TG) and blood pressure (BP)were determined. The serum concentrations of ADMA were measured by high-performance liquid chromatography.RESULTS: 1, There were statistically significant differences in ADMA, SBP, BS> TC\ LDL-C levels between CAD group and controls. 2, Bivariate correlation demonstrated that the serum ADMA was positively related to SBP, BS and LDL-C in CAD group. 3 > The serum concentrations of ADMA were significantly higher in the subgroups as compared to controls.There was no difference in the concentrations of serum ADMA betweenUAP and AMI, whereas significantly higher levels of ADMA were observed in UAP and AMI than SAP. 4> The serum concentrations of ADMA were significantly higher in the groups of mild and serious coronary artery disease as compared to controls.There was significant difference in the concentrations of serum ADMA between these two groups.CONCLUSIONrElevated serum ADMA levels are associated with CAD and its risk factors such as hyperglycemia,hypertension and hypercholesterolemia.Elevation of ADMA induces dysfunction of the endothelium,which becomes clinically evident by impaired endothelium-dependent vasodilation, hyperaggregability of platelets, and enhanced monocyte adhesion. Elevated serum ADMA levels are also associated with the clinical syndrom and coronary artery disease. The higher the serum ADMA is, the more serious the clinical syndrom is, and the more unstable the plaque is. According to the recent prospective studies, ADMA may be a new risk factor of CAD, a marker of unstable state of illness. It may be used to detect vulnerable plaque earlier, define the risk and contribute to the treatment of CAD.