Elevated plasma asymmetric dimethylarginine level in acute myocardial infarction patients as a predictor of poor prognosis and angiographic impaired reperfusion

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dc.authoridOzcan, Firat/0000-0002-7954-7839
dc.authoridSokmen, Erdogan/0000-0002-8170-5912
dc.contributor.authorSen, Nihat
dc.contributor.authorOzlu, Mehmet Fatih
dc.contributor.authorAkgul, Emin Ozgur
dc.contributor.authorKanat, Selcuk
dc.contributor.authorCayci, Tuncer
dc.contributor.authorTurak, Osman
dc.contributor.authorYaman, Halil
dc.date.accessioned2024-09-18T20:02:43Z
dc.date.available2024-09-18T20:02:43Z
dc.date.issued2011
dc.departmentHatay Mustafa Kemal Üniversitesien_US
dc.description.abstractObjectives: We aimed to investigate the effects of admission asymmetric dimethylarginine (ADMA) levels on myocardial perfusion and prognosis in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Background: ADMA, an endogenous inhibitor of endothelial nitric oxide synthase, was found to be elevated in plasma of patients with cardiovascular risk factors. Methods: 168 consecutive patients undergoing primary PCI for STEMI <12 h after symptom onset and 75 healthy age and sex matched volunteer controls were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission plasma ADMA levels. Major adverse cardiac events during hospitalization or at one-year clinical follow-up were evaluated. Also angiographic impaired reperfusion was assessed by 3 different methods after PCI: angiographic thrombolysis in myocardial infarction (TIMI) flow, TIMI frame count and TIMI myocardial perfusion grade (TMPG). Results: Plasma level of l-arginine were lower in patients with STEMI than in the control group subjects, whereas plasma ADMA levels were increased in the STEMI patient group. The rate of impaired angiographic reperfusion increased across the tertile groups. Also one-year mortality rates showed a significant increase across the tertile groups (4% vs. 10% vs. 20%, p < 0.01). Using multiple Cox regression analysis, only TIMI risk score, left ventricle ejection fraction (LVEF), abnormal TMPG, and increased ADMA values on admission emerged as independent predictors of one-year mortality. The ROC analysis indicated an optimal cut-point of >= 1.37 mu mol/L, which detects one-year mortality with a negative predictive value of 96%. Conclusions: In STEMI patients undergoing primary PCI, high admission ADMA levels were found to be associated with impaired myocardial perfusion and increased one-year mortality. Therefore admission ADMA level detection may be helpful in identifying the patients at a greater risk of impaired myocardial perfusion and poor prognosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.en_US
dc.identifier.doi10.1016/j.atherosclerosis.2011.06.021
dc.identifier.endpage310en_US
dc.identifier.issn0021-9150
dc.identifier.issue1en_US
dc.identifier.pmid21726864en_US
dc.identifier.scopus2-s2.0-80055002137en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage304en_US
dc.identifier.urihttps://doi.org/10.1016/j.atherosclerosis.2011.06.021
dc.identifier.urihttps://hdl.handle.net/20.500.12483/7983
dc.identifier.volume219en_US
dc.identifier.wosWOS:000296587200046en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Ireland Ltden_US
dc.relation.ispartofAtherosclerosisen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAsymmetric dimethylarginineen_US
dc.subjectST segment elevation myocardial infarctionen_US
dc.subjectPercutaneous coronary interventionen_US
dc.subjectPrognosisen_US
dc.titleElevated plasma asymmetric dimethylarginine level in acute myocardial infarction patients as a predictor of poor prognosis and angiographic impaired reperfusionen_US
dc.typeArticleen_US

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