Original article Asymmetric dimethylarginine levels in patients with coronary artery ectasia

Abstract

Background: Endothelial dysfunction might be one of the pathophysiological mechanisms in the development of coronary artery ectasia (CAE) although the exact mechanisms have not yet been demonstrated. Asymmetric dimethylarginine (ADMA), an endogenous competitive inhibitor of nitric oxide synthase, is also related to endothelial and structural dysfunction.
Aim: To asses the relationship between CAE and ADMA plasma concentrations.
Methods: Thirty patients with CAE in a mean age of 55.5 ± 3.6 years and 40 patients with normal coronary arteries in a mean age of 53.3 ± 11.6 years were studied. The ADMA levels of all patients were analysed by ELISA method.
Results: The mean ADMA level in the CAE group was found to be significantly higher than the mean ADMA level in the normal coronary artery group (2.26 ± 0.47 vs. 1.43 ± 0.40 µmol/l, p < 0.001). The elevated ADMA level (> 1.80 µmol/l) was present in 83.0% of patients from the CAE group and 25.0% of patients from the normal coronary artery group (p < 0.001). Having an increased ADMA level enhanced the risk of CAE 15-fold. The multiple-adjusted OR of the risk of CAE was 18.71 (95% CI 4.95-70.68) for the higher ADMA level compared to the lower level.
Conclusion: Asymmetric dimethylarginine level is significantly associated with the presence of coronary artery ectasia. These findings suggest that increased ADMA level may be associated with endothelial dysfunction leading to the development of coronary artery ectasia.