Asymmetric Dimethyl Arginine Relationship With Coronary Artery And Its Prognosis

BackgroundCoronary artery ectasia (CAE) is a non-obstructive coronary artery disease, defined as dilatation of an arterial segment to a diameter at least1.5times that of the adjacent normal coronary artery. So far the etiology is unclear, but atherosclerosis might be the mechanism underlying the pathogenesis of CAE. Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of endothelial nitric oxide synthase and an important cause of endothelial dysfunction and atherosclerosis. Many studies have implicated ADMA is. an independent predictor of coronary artery disease. Considering atherosclerosis as a possible mechanism of CAE, it would be helpful to be focus on the association between ADMA level and CAE.Objectives1. Investigate the clinical manifestation and prognosis of CAE.2. Investigate the relationship between nitric oxide (NO) and CAE and its prognosis.3. Investigate the relationship between ADMA and CAE and its prognosis.Methods1. Consecutive patients referred to the ward of cardiology department, cardiac care unit and emergency of PUMC for percutaneous coronary intervention from February2005to December2009were enrolled in this study, and their plasma samples and clinical information were collected after informed consent. They were followed up prospectively for3years and the major adverse cardiac events were considered as terminal event.2. Measure NO level by method of nitric acid reductase, and investigate the relationship between nitric oxide (NO) and CAE and its prognosis.3. Measure ADMA level by HPLC-MS/MS, and investigate the relationship between ADMA and CAE and its prognosis.Results1. A total of74cases were selected, including34cases in CAE group,40cases in control group, and received follow-up results from64patients. No signidicant difference of clinical manifestation and prognosis exists between these two groups. Comparing the subgroups of CAE, the age and incidence of MACE might correlate with the severity of coronary artery atherosclerosis. 2. No signidicant difference of NO level exists between CAE and control group, and NO level of CAE group correlates with BMI positively.3. No signidicant difference of ADMA relevant items exists between CAE and control group. ADMA level of CAE group correlates with BMI negatively. Arg/ADMA is an independent protect factor of CAE.4. The severity of collateral coronary artery atherosclerosis in CAE patients might be the risk factor of incidence of MACE, not the dilation of coronary artery.Conclusion1. No signidicant difference of ADMA relevant items exists between CAE and control group.2. Arg/ADMA is an independent protect factor of CAE.