Asymmetric Dimethylarginine (ADMA) Levels Display a Morning Peak in Patients with Acute Myocardial Infarction

Abstract

Abstract. High Asymmetric Dimethylarginine (ADMA) levels are associated with increased platelet activity, elevated blood pressure, vasoconstriction and impaired vascular relaxation. We hypothesized that the myocardial infarction morning peak of occurrence is closely related to a morning peak of ADMA levels. We performed a cross-sectional study among patients with documented myocardial infarction who had been enrolled in the prospective MISSION! Intervention Study. In total, serum ADMA levels were measured in their acute setting of myocardial infarction in 120 patients. The frequency of myocardial infarction onset of symptoms and emergency coronary catheterization and the ADMA levels displayed a similar daily pattern with a morning peak between 06:00-11:59 h. The absolute ADMA levels peak was between 06:00-07:59 h with a median (interquartile range) peak value of 1.01 (0.84-1.21) µmol/L for the n = 9 patients vs. 0.75 (0.61-0.89) µmol/L for the remaining 111 patients admitted throughout the rest of the 24-hour interval (p = 0.003 for between groups comparison). The amplitude (95% confidence interval) of the circadian variation of ADMA levels was 0.08 µmol/L (0.004-0.16) with p = 0.042 for statistic model significance. In conclusion, ADMA levels display a 24-hour variation with a significant morning peak in patients with acute myocardial infarction. These findings may relate ADMA levels to the acute onset of thrombotic cardiovascular events.

Arginine deficiency measured by global arginine bioavailability ratio in patients with acute coronary syndrome

“…To our knowledge, there have been no reports about circadian variation of GABR. Only one paper suggested that serum ADMA concentration has diurnal variation with a morning peak 36) , which is the opposite pattern to that of endothelial function. In the present study, time of day of blood sampling varied depending on the schedule of coronary angiography, which could obscure the differences in GABR and ADMA values between patients with or without CAD because of diurnal variation.…”

Impact of the circadian clock on fibrinolysis and coagulation in healthy individuals and cardiovascular patients – A systematic review

“…A total number of 20 out of 25 relevant articles investigated the circadian rhythms impact on coagulation, fibrinolysis, or both in healthy persons only or together with cardiovascular patients [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The remaining articles addressed the same question in cardiovascular patients only and represent four different study designs; two longitudinal observational studies [32,33], One comparative retrospective study [34] and One cross-sectional study [35].…”

“…Two studies found a circadian rhythm of Lp(a) or ADMA [34,35]. Both studies only included AMI patients, but represent two different study designs.…”

“…ADMA was investigated in a cross-sectional study and was found to peak between 6 am and noon. The study controlled for aspirin, clopidogrel and statins intake, but none of those were found to significantly influence the values of ADMA [35].…”

Mathematical Model for Assessment of Risk of the Development of Life - Threatening Complications in Acute Phase of Myocardial Infarction

“…данным ряда исследований, TFN является косвенным маркером ЭД[6; 7].Асимметричный диметиларгинин (ADMA) является эндогенным ингибитором синтазы оксида азота (NO), маркером ЭД. Повышение его уровня связано с риском острых коронарных событий, нарушениями перфузии миокарда и неблагоприятным прогнозом у пациентов с ИМ[8].Еще одним перспективным биомаркером воспаления и ЭД является цитокинфракталкин/CX3CL1[9]. В доступной литературе представлены единичные исследования по изучению его уровня у пациентов с ИМ.…”