ADMA and NT pro‐BNP are associated with overall mortality in elderly

Abstract

Background Increased asymmetrical dimethylarginine ( ADMA ) and NT pro‐ BNP concentrations have been associated with mortality in patients with cardiovascular ( CV ) disease and the general population. The use of these prognostic markers in an older population is not established yet. The aim of the present study was to investigate the prognostic value of age, sex, BMI , co‐medication and CV laboratory risk markers in geriatric care patients. Materials and methods In this prospective observational single‐centre cohort study data of long‐term geriatric care patients were collected. Blood samples were collected between 14.09.2009 and 16.12.2009, and mortality was recorded up to 90 months. ADMA , its symmetric isomer SDMA , L‐arginine, NT pro‐ BNP and CRP were determined at study entry. Simple associations of risk factors for survival period were explored by Spearman correlation coefficient. Significant univariate predictors for survival period were used in the Cox proportional hazard model. Results A total of 481 patients were screened, and data from 449 patients were analysed. A total of 381 patients died during the observation period. Full data sets from 344 patients were used for Cox regression analysis. Male sex, older age, lower BMI , use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA , NT pro‐ BNP , and CRP were significant predictors of mortality. Conclusion The concentration of ADMA and NT pro‐ BNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with increased mortality in this population.

The Relationship of Left Ventricular Diastolic Dysfunction and Asymmetrical Dimethylarginine as a Biomarker of Endothelial Dysfunction with Cardiovascular Risk Assessed by Systematic Coronary Risk Evaluation2 Algorithm and Heart Failure—A Cross-Sectional Study

“…Second, the same groups of drugs did not have the same effect regarding lowering plasma NT-proBNP concentration. Third, in contrast to previously published studies [15,18,19], we did not confirm a positive correlation of plasma ADMA concentration with NT-proBNP or the prevalence and severity of LVDD, HF, NYHA class, or CV risk, probably due to the previously mentioned drug influence. Fourth, similarly to other studies, we also confirmed that there is a positive correlation between the prevalence and severity of LVDD, CV risk factors, CVDs [5][6][7], estimated CV risk [36], NT-proBNP concentration [37], and HF [38,39].…”

“…All CV risk factors known so far, as well as CVDs, increase the concentration of ADMA in such a way that they lead to the excessive formation or inhibition of its degradation [17]. We found in the literature that ADMA showed a positive correlation with the incidence of LVDD [18] and N-terminal pro-brain NP (NT-proBNP) values [19], and, similarly to NT-proBNP, can further improve the stratification of the risk of cardiac decompensation, major adverse CV events, and mortality in patients with HF [20,21]. Through our research, we aimed to determine whether we could contribute to a personalized understanding of the (residual) CV risk assessed via the SCORE2 algorithm by measuring the plasma concentration of the biomarkers ADMA and NT-proBNP with dependence on LVDD.…”

Risk factors for poor prognosis in heart failure with particular attention to the elderly population

“…Particular attention should be paid to the role of the assessment of natriuretic peptides in older patients hospitalized due to exacerbation of HF. It is known that NT-proBNP predicts mortality among the older and very elderly patients with chronic HF [33]. In the elderly population with HF, the higher cut-off value for NT-proB-NP should be considered.…”

Impact of combined elevations of homocysteine and asymmetric dimethylarginine on all-cause death ― The Tanushimaru Study

“…Compared to Hcy, significant associations of ADMA with mortality are limited to subjects with end-stage renal disease [11] , angiographic coronary artery disease (CAD) [12] , acute myocardial infarction [13] , after percutaneous coronary intervention [14] , and patients aged over 65 years old [15] . Two cohort studies [ 16 , 17 ] maru, a cohort of the Seven Countries Study [19] ).…”