Effects of stent implementation on plasma levels of asymmetric dimethylarginine in patients with or without ST-segment elevation acute myocardial infarction

Abstract

Abstract.The study was designed to compare the response pattern of plasma l-arginine and methylarginines to stent placement in patients with or without ST segment elevation myocardial infarction (STEMI). Two groups of patients with obstructive coronary artery disease (OCAD) undergoing percutaneous coronary intervention (PCI) with stenting were enrolled in the study. Group I consisted of 16 patients with STEMI, whereas group II included 24 patients without STEMI (controls). Before PCI and at <1 h, 5 and 30 days after reperfusion, blood samples were taken for measurement of l-arginine and methylarginines. L-arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), N-monomethylarginine (MMA) and l-ornithine plasma levels were measured by LC-MS-MS. Arginine methylation index (Arg-MI) was calculated according to the formula, Arg-MI = (ADMA+SDMA)/MMA. In patients without STEMI, stenting induced a prompt and sustained depression of ADMA (p<0.000), and l-ornithine (p<0.000) with simultaneous increase of l-arginine (p<0.001), l-arginine/ ADMA ratio (p<0.000) and an inconsistent change in MMA. Arg-MI remained at the baseline value. By contrast, STEMI patients responded to stent placement with a variable increase in l-arginine (p<0.01), ADMA (p<0.069), SDMA, MMA (p<0.01) and l-ornithine (p<0.000), whereas there was an early fall of Arg-MI after stenting, followed by a steady increase approaching the initial values. The differences in the timecourse for ADMA (p<0.000), MMA (p<0.007), Arg-MI (p<0.01) and l-ornithine (p<0.003) proved to be significant between the STEMI and control group. It can be concluded therefore, that stent placement improves endothelial dysfunction in patients with OCAD when it is not complicated by STEMI.

L-Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice

“…The standard therapy for acute ST segment elevation-indicating myocardial infarction-is PCI. Thus in order to see the importance of L-arginine and its derivatives we measured the plasma level of L-Arg, ADMA, and SDMA ( Figure 4) immediately after PCI (Ajtay et al, 2010).…”

“…The underlying pathomechanisms could be that the increased level of oxidative stress activates PRMT-1 and at the same time inhibits DDAH, resulting in an elevated ADMA level. The high circulating ADMA level not only can inhibit eNOS activity but also uncouple this enzyme leading FIGURE 4 | Plasma levels of asymmetric dimethylarginine (ADMA) in patients with coronary artery disease undergoing percutaneous coronary intervention with stent placement with or without (control group) ST segment elevation myocardial infarction (Ajtay et al, 2010). Segment elevation myocardial infarction (STEMI) group indicates patients with ST segment elevation myocardial infarction.…”