Plasma Asymmetric Dimethylarginine and Adverse Events in Patients with Atrial Fibrillation Referred for Coronary Angiogram

Tze Fan Chao, Tse Min Lu, Yenn Jiang Lin, Hsuan Ming Tsao, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Ming Hsiung Hsieh, Shih Ann Chen

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives:Elevated plasma levels of asymmetric dimethylarginine (ADMA) have been reported to be associated with endothelial dysfunction, inflammation, and oxidative stress in multiple cardiovascular diseases. This study aimed to investigate whether ADMA was a predictor of clinical outcomes in atrial fibrillation (AF).Methods and Results:From 2006-2009, 990 individuals were referred to our institution for coronary angiography. Among these patients, 141 subjects with a diagnosis of AF, including 52 paroxysmal AF (PAF) and 89 non-paroxysmal AF (non-PAF) patients, were identified as the study population. Plasma ADMA levels were measured. An adverse event was defined as the occurrence of ischemic stroke or cardiovascular death. The ADMA levels were higher in AF than non-AF patients (0.50±0.13 versus 0.45±0.07 μmol/L; p2DS2-VASc score, and left atrial diameter were independent predictors of adverse events in the multivariate analysis. At a cutoff-value of 0.55 μmol/L, the Kaplan-Meier survival analysis showed that patients with a high ADMA level had a higher event rate during the follow-up period.Conclusions:A higher level of ADMA was a risk factor of adverse events in AF patients, which was independent from the CHA2DS2-VASc score. It deserves to further study whether ADMA could potentially refine the clinical risk stratification in AF.

Original languageEnglish
Article numbere71675
JournalPLoS One
Volume8
Issue number8
DOIs
Publication statusPublished - Aug 7 2013

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Atrial Fibrillation
Angiography
Plasmas
Oxidative stress
Kaplan-Meier Estimate
Survival Analysis
N,N-dimethylarginine
atrial fibrillation
Coronary Angiography
stroke
cardiovascular diseases
multivariate analysis
Oxidative Stress
oxidative stress
Cardiovascular Diseases
risk factors
Multivariate Analysis
inflammation
Myocardial Infarction
death

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Chao, T. F., Lu, T. M., Lin, Y. J., Tsao, H. M., Chang, S. L., Lo, L. W., ... Chen, S. A. (2013). Plasma Asymmetric Dimethylarginine and Adverse Events in Patients with Atrial Fibrillation Referred for Coronary Angiogram. PLoS One, 8(8), [e71675]. https://doi.org/10.1371/journal.pone.0071675

Plasma Asymmetric Dimethylarginine and Adverse Events in Patients with Atrial Fibrillation Referred for Coronary Angiogram. / Chao, Tze Fan; Lu, Tse Min; Lin, Yenn Jiang; Tsao, Hsuan Ming; Chang, Shih Lin; Lo, Li Wei; Hu, Yu Feng; Tuan, Ta Chuan; Hsieh, Ming Hsiung; Chen, Shih Ann.

In: PLoS One, Vol. 8, No. 8, e71675, 07.08.2013.

Research output: Contribution to journalArticle

Chao, Tze Fan ; Lu, Tse Min ; Lin, Yenn Jiang ; Tsao, Hsuan Ming ; Chang, Shih Lin ; Lo, Li Wei ; Hu, Yu Feng ; Tuan, Ta Chuan ; Hsieh, Ming Hsiung ; Chen, Shih Ann. / Plasma Asymmetric Dimethylarginine and Adverse Events in Patients with Atrial Fibrillation Referred for Coronary Angiogram. In: PLoS One. 2013 ; Vol. 8, No. 8.
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AB - Objectives:Elevated plasma levels of asymmetric dimethylarginine (ADMA) have been reported to be associated with endothelial dysfunction, inflammation, and oxidative stress in multiple cardiovascular diseases. This study aimed to investigate whether ADMA was a predictor of clinical outcomes in atrial fibrillation (AF).Methods and Results:From 2006-2009, 990 individuals were referred to our institution for coronary angiography. Among these patients, 141 subjects with a diagnosis of AF, including 52 paroxysmal AF (PAF) and 89 non-paroxysmal AF (non-PAF) patients, were identified as the study population. Plasma ADMA levels were measured. An adverse event was defined as the occurrence of ischemic stroke or cardiovascular death. The ADMA levels were higher in AF than non-AF patients (0.50±0.13 versus 0.45±0.07 μmol/L; p2DS2-VASc score, and left atrial diameter were independent predictors of adverse events in the multivariate analysis. At a cutoff-value of 0.55 μmol/L, the Kaplan-Meier survival analysis showed that patients with a high ADMA level had a higher event rate during the follow-up period.Conclusions:A higher level of ADMA was a risk factor of adverse events in AF patients, which was independent from the CHA2DS2-VASc score. It deserves to further study whether ADMA could potentially refine the clinical risk stratification in AF.

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