Dimethylarginines, blood glucose, and C-reactive protein in patients with acute myocardial infarction

Abstract

Background

Asymmetric dimethylarginine (ADMA), and its symmetrical stereoisomer (SDMA) — as methylated products of l-arginine, decrease nitric oxide (NO) availability. Their elevated levels in diabetes increase the risk of acute myocardial infarction (MI), through endothelial dysfunction.

Aims

We investigated the relationship between circulating levels of ADMA, SDMA and functional relevant parameters in patients with acute MI.

Methods

Prospective study from 31 MI patients hospitalized < 12 h after symptom onset. Blood samples were taken on admission and serum levels of ADMA, SDMA and l-arginine were determined using high-performance liquid chromatography (HPLC).

Results

Mean age was 65y, most were male, hypertensive, 1/3rd were current smokers, or had a history of CAD and 23% were diabetic. ADMA and l-arginine values were similar whatever the risk factor, except for ADMA that was positively correlated with blood glucose (r = 0.37). In contrast, SDMA was correlated with age (r = 0.43), and admission glucose (r = 0.57). SDMA was elevated in hypertension, prior CAD, statin therapy and showed a trend toward an increase in diabetic patients (p = 0.191). Moreover, there was a trend toward an elevation of SDMA with decreased LVEF (r = − 0.25). In multivariate linear regression analysis, blood glucose was an estimate of SDMA (ß = 0.373, p = 0.025), beyond traditional markers of dimethylarginines including kidney failure.

Conclusion

Our study showed that in patients with acute MI, SDMA, and only weakly ADMA, are associated with admission blood glucose, beyond traditional dimethylarginine determinants and may therefore have biological activity beyond renal function.