circulating levels of dimethylarginines, chronic kidney disease and long-term clinical outcome in non-st-elevation myocardial infarction循环水平dimethylarginines,慢性肾脏疾病和长期non-st-elevation心肌梗塞的临床结果.pdfVIP

Circulating Levels of Dimethylarginines, Chronic Kidney Disease and Long-Term Clinical Outcome in Non-ST- Elevation Myocardial Infarction 1,2 1 1 1 1 Viviana Cavalca *, Fabrizio Veglia , Isabella Squellerio , Monica De Metrio , Mara Rubino , 1 1 1,3 1 Benedetta Porro , Marco Moltrasio , Elena Tremoli , Giancarlo Marenzi ` ` 1 Centro Cardiologico Monzino, I.R.C.C.S, Milan, Italy, 2 Dipartimento di Scienze Cliniche e di Comunita, Universita degli Studi di Milano, Milan, Italy, 3 Dipartimento di ` Scienze Farmacologiche e Biomolecolari, Universita degli Studi di Milano, Milan, Italy Abstract Background: Mechanisms linking chronic kidney disease (CKD) and adverse outcomes in acute coronary syndromes (ACS) are not fully understood. Among potential key players, reduced nitric oxide (NO) synthesis due to its endogenous inhibitors, asymmetric (ADMA) and symmetric (SDMA) dimethylarginine could be involved. We measured plasma concentration of arginine, ADMA and SDMA and investigated their relationship with CKD and long-term outcome in non-ST-elevation myocardial infarction (NSTEMI). Methodology/Principal Findings: We prospectively measured arginine, ADMA, and SDMA at hospital admission in 104 NSTEMI patients. CKD was defined as an estimated glomerular filtration rate (eGFR) ,60 ml/min/1.73 m2. We considered a primary end point of combined cardiac death and re-infarction at a median follow-up of 21 months. In CKD (n = 33) and no-