Krempl Tanja K, Maas Renke, Sydow Karsten, Meinertz Thomas, Böger Rainer H, Kähler Jan
Institute of Experimental and Clinical Pharmacology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Eur Heart J. 2005 Sep;26(18):1846-51. doi: 10.1093/eurheartj/ehi287. Epub 2005 Apr 28.
We investigated the role of asymmetric dimethylarginine (ADMA) for clinical outcome of patients with unstable angina.
Forty-five patients with stable angina, 36 patients with unstable angina, and 40 healthy controls were included in this study. Coronary artery disease (CAD) patients were prospectively followed for 1 year. ADMA levels were measured at baseline and after 6 weeks using a validated ELISA. Baseline ADMA concentration in controls was significantly lower than in patients with CAD (0.59+/-0.23 vs. 0.76+/-0.17 micromol/L; P<0.001). Patients with unstable angina had significantly higher baseline ADMA levels than patients with stable angina (0.82+/-0.18 vs. 0.73+/-0.15 micromol/L; P=0.01). There was a significant reduction of ADMA levels at 6 weeks after percutaneous coronary intervention (PCI) in patients with unstable angina who experienced no recurrent cardiovascular event (from 0.81+/-0.14 to 0.73+/-0.19 micromol/L; P<0.05). In contrast, patients with unstable angina who had an event showed no significant decrease in ADMA at 6 weeks. Actuarial survival analysis showed a significantly higher event rate in patients with persistently elevated ADMA plasma concentrations.
ADMA is significantly elevated in patients with unstable angina. A reduced ADMA level at 6 weeks after PCI may indicate a decreased risk of recurrent cardiovascular events.
我们研究了不对称二甲基精氨酸（ADMA）在不稳定型心绞痛患者临床预后中的作用。
本研究纳入了45例稳定型心绞痛患者、36例不稳定型心绞痛患者和40例健康对照者。对冠心病（CAD）患者进行了为期1年的前瞻性随访。使用经过验证的酶联免疫吸附测定法（ELISA）在基线和6周后测量ADMA水平。对照组的基线ADMA浓度显著低于CAD患者（0.59±0.23 vs. 0.76±0.17微摩尔/升；P<0.001）。不稳定型心绞痛患者的基线ADMA水平显著高于稳定型心绞痛患者（0.82±0.18 vs. 0.73±0.15微摩尔/升；P=0.01）。在接受经皮冠状动脉介入治疗（PCI）后6周，未发生复发性心血管事件的不稳定型心绞痛患者的ADMA水平显著降低（从0.81±0.14降至0.73±0.19微摩尔/升；P<0.05）。相比之下，发生事件的不稳定型心绞痛患者在6周时ADMA没有显著下降。精算生存分析显示，ADMA血浆浓度持续升高的患者事件发生率显著更高。
不稳定型心绞痛患者的ADMA显著升高。PCI后6周ADMA水平降低可能表明复发性心血管事件风险降低。
