Association between asymmetric dimethylarginine and in-stent restenosis tissue characteristics assessed by optical coherence tomography

Qiao

et al. 2020

BMC Cardiovasc Disord

Background Percutaneous coronary intervention (PCI) is a common treatment for patients with coronary heart disease, and intra-stent restenosis (ISR) is a serious complication after PCI. It’s necessary to identify the potential risk factors to provide evidence for the prevention of ISR. Methods The patients who underwent coronary angiography 1 year after PCI in our hospital from January 2017 to May 2019 were selected. The characteristics and results of clinical examination of ISR and no-ISR patients were compared, Multivariate logistic regression analyses were performed to identify the risk factors. Results A total of 209 patients were included, the incidence of ISR after PCI was 30.62%. There were significant differences on the hypertension, diabetes, number of coronary artery lesions, reasons for stent implantation, the diameter of stent, the length of stent and stent position between ISR group and no-ISR patients (all p < 0.05). The LDL-C in ISR groups was significantly higher than that of no-ISR group (p = 0.048), there were no significant differences between two groups in FPG, TG, TC, HDL-C, Apo A1, Apo B, LP-a and glycated haemoglobin (all p > 0.05). The hypertension (OR 4.30, 95% CI 1.12–9.34), diabetes (OR 5.29, 95% CI 1.25–9.01), number of coronary artery lesions ≥ 2 (OR 4.84, 95% CI 1.21–9.55), LDL-C ≥ 1.9 mmol/L (OR 5.93, 95% CI 2.29–10.01), unstable angina (OR 2.92, 95% CI 1.20–4.55), left anterior descending artery (OR 4.01, 95% CI 1.73–7.58), diameter of stent ≥ 3 mm (OR 5.42, 95% CI 1.24–10.84), the length of stent > 20 mm (OR 3.06, 95% CI 1.19–5.22) were the independent risk factor for ISR (all p < 0.05). Conclusion It is necessary to take preventive measures against these risk factors to reduce ISR, and studies with larger sample size and longer follow-up on this issue are needed in the future.

Section: Discussionmentioning

confidence: 99%

The characteristics and risk factors of in-stent restenosis in patients with percutaneous coronary intervention: what can we do

Qiao

et al. 2020

BMC Cardiovasc Disord

“…This suggests that either the plaque itself or the associated ischemic condition is a factor contributing to raised ADMA concentration [ 99 ]. However, following stenting, ADMA is a determining factor as to whether re-stenosis occurs, with ADMA concentrations correlating with in-stent calcification and neoatherosclerosis [ 100 ]. Stenting can cause endothelial damage.…”

Section: Underlying Mechanisms Of Atherosclerosismentioning

confidence: 99%

ADMA: A Key Player in the Relationship between Vascular Dysfunction and Inflammation in Atherosclerosis

Dowsett

Higgins

Alanazi

et al. 2020

JCM

Atherosclerosis is a chronic cardiovascular disease which increases risk of major cardiovascular events including myocardial infarction and stroke. Elevated plasma concentrations of asymmetric dimethylarginine (ADMA) have long been recognised as a hallmark of cardiovascular disease and are associated with cardiovascular risk factors including hypertension, obesity and hypertriglyceridemia. In this review, we discuss the clinical literature that link ADMA concentrations to increased risk of the development of atherosclerosis. The formation of atherosclerotic lesions relies on the interplay between vascular dysfunction, leading to endothelial activation and the accumulation of inflammatory cells, particularly macrophages, within the vessel wall. Here, we review the mechanisms through which elevated ADMA contributes to endothelial dysfunction, activation and reactive oxygen species (ROS) production; how ADMA may affect vascular smooth muscle phenotype; and finally whether ADMA plays a regulatory role in the inflammatory processes occurring within the vessel wall.

“…The association between ADMA elevation and adverse outcomes in CAG/PCI population may be explained by the underlying mechanisms. First, high ADMA level was associated with the development of in-stent neoatherosclerosis and calcification [23], which cause a series of cardiovascular events. Second, increased ADMA level can reflect oxidative stress or endothelial dysfunction, which result in adverse cardiovascular outcomes and mortality.…”

Section: Discussionmentioning

confidence: 99%

Elevated asymmetric dimethylarginine level as biomarkers of adverse outcomes in individuals undergoing coronary angiography/percutaneous coronary interventions: a systematic review and meta-analysis

Coronary Artery Disease

Wanga²,

Xu³

2021

Background No previous systematic review and metaanalysis have comprehensively evaluated the association of asymmetric dimethylarginine (ADMA) level with adverse prognosis in individuals undergoing percutaneous coronary interventions (PCI)/coronary angiography (CAG). The aim of this systematic review and meta-analysis was to assess the predictive value of the elevated ADMA level in individuals undergoing CAG/PCI. Materials and methodsTwo authors independently searched PubMed and Embase databases (up to 31 October 2020) for observational studies investigating the association between circulating ADMA level and adverse outcomes in individuals undergoing CAG/PCI. The predictive value of ADMA was expressed by pooling the multivariable-adjusted risk ratio with 95% confidence intervals (CI) for the highest versus lowest ADMA level.Results A total of nine prospective studies with 6374 participants were identified. Compared with those with the lowest ADMA level, patients with the highest ADMA level conferred an increased risk of all-cause mortality (risk ratio, 2.11; 95% CI, 1.38-3.21), cardiovascular mortality (risk ratio, 2.95; 95% CI, 1.14-7.68), major adverse cardiovascular events (risk ratio, 2.10; 95% CI, 1.35-3.27) and restenosis (risk ratio, 4.57; 95% CI, 2.52-8.30), respectively.Conclusions High level of ADMA level is possibly an independent predictor of mortality and cardiovascular events in individuals undergoing CAG/PCI. Detection of blood ADMA level before CAG/PCI may add valuable clinical prognosis information. Coron Artery Dis 33: e80-e86