Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey.
Clin Chem Lab Med. 2011 May;49(5):903-7. doi: 10.1515/CCLM.2011.148. Epub 2011 Mar 2.
Increased concentrations of asymmetric dimethylarginine (ADMA) have been detected in patients with cardiovascular risk factors. In addition, high baseline plasma concentrations of ADMA have been shown to be an independent predictor of adverse outcomes in various disorders. This study aimed to evaluate the impact of admission ADMA concentrations on microvascular flow after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).
Blood samples from 39 patients with STEMI were collected at admission to measure the concentrations of ADMA and other cardiovascular risk factors including inflammatory markers and the lipid profile. Primary PCI was performed in patients with STEMI. The maximum ST-segment elevation in standard 12-leads electrocardiogram (ECG) before and 24 h after PCI was measured, and patients were stratified as complete or incomplete ST-segment resolution (STR).
Twenty-five patients had complete (≥ 70%) and 14 incomplete (<70%) STR. In patients with incomplete STR, ADMA concentrations were significantly higher than that seen in others (0.447 ± 0.215 μmol/L vs. 0.310 ± 0.134, p=0.019), and was independently associated with STR.
Admission concentrations of ADMA appeared to be useful for early risk stratification in reperfusion therapy for acute myocardial infarction.
心血管危险因素患者的不对称二甲基精氨酸（ADMA）浓度升高。此外，ADMA 的基线血浆浓度较高已被证明是各种疾病不良预后的独立预测因子。本研究旨在评估 ST 段抬高型心肌梗死（STEMI）患者入院时 ADMA 浓度对经皮冠状动脉介入治疗（PCI）后微血管血流的影响。
收集 39 例 STEMI 患者入院时的血样，以测量 ADMA 浓度和其他心血管危险因素，包括炎症标志物和血脂谱。对 STEMI 患者进行经皮冠状动脉介入治疗。测量标准 12 导联心电图（ECG）上 PCI 前后最大 ST 段抬高，并将患者分为完全（≥70%）和不完全（<70%）ST 段缓解（STR）。
25 例患者有完全（≥70%）和 14 例不完全（<70%）STR。在不完全 STR 的患者中，ADMA 浓度明显高于其他患者（0.447±0.215μmol/L 比 0.310±0.134μmol/L，p=0.019），并且与 STR 独立相关。
入院时 ADMA 浓度似乎可用于急性心肌梗死后再灌注治疗的早期危险分层。
