ABSTRACT

It is unclear whether abnormalities of nitric oxide (NO) are related to hemodynamic dysfunction and mortality in patients after acute myocardial infarction (MI). We investigated the relationship of plasma asymmetric dimethylarginine (ADMA) and NO levels with early prognosis in patients with MI.

Fifty-nine patients (9 females, 50 males, aged 32-75) hospitalized in the Coronary Care Unit were included in the study. Blood samples were obtained on the first day of admission for routine hematological and biochemical tests and for plasma ADMA and NO levels. NO was determined as the concentration of nitrate plus nitrite (NO metabolites) spectrophotometrically at 430 nm using the Griess reaction. ADMA concentrations were determined by competitive ELISA assay. One month after MI, echocardiography was performed on 56 patients who survived, and left ventricular ejection fraction (LVEF) was investigated as a prognostic marker of cardiac function.

There was no correlation between ADMA and NO levels with age, gender, smoking, localization of the infarction, history of hypertension, coronary heart disease or diabetes mellitus, and the levels of total cholesterol, triglyceride, lactate dehydrogenase, white blood cells, and Creactive protein. Plasma ADMA concentrations were negatively correlated with NO levels (r=-0.72) and creatine kinase -MB levels (r=-0.37). LVEF had no correlation with ADMA or NO levels (p>0.05).

In previous studies, decreased NO and high levels of ADMA were proposed as independent risk factors for coronary artery disease. Although MI patients had higher ADMA levels, they showed no correlation with left ventricular systolic function or early cardiac events.

Keywords: Asymmetric dimethylarginine, endothelial dysfunction, myocardial infarction, nitric oxide, left ventricular dysfunction