Relation Between Serum Asymmetric Dimethylarginine Levels and Radial Artery Spasm

Abstract

Objective: The use of the radial approach in coronary angiography or percutaneous coronary intervention has increased owing to its advantages over the femoral approach such as rapid patient mobilization and improved patient comfort. However, radial artery spasm (RAS) that occurs during the procedure is a crucial factor in transradial approach failure and access site switch. Asymmetric dimethylarginine (ADMA) is a naturally occurring, modified amino acid that inhibits nitric oxide (NO) production. High ADMA levels may reduce arterial elasticity especially in small arteries like the radial artery. This study aimed to evaluate the relationship between ADMA levels and RAS in radial artery access. Methods: This study included 155 patients (89 males and 66 females) who underwent transradial coronary angiography between January 2016 and June 2016. The ADMA level in the plasma was determined using a quantitative sandwich enzyme immunoassay technique. Results: RAS was observed in 16 of the 155 patients (10.1%). The RAS was found to be more frequent in female patients (17.9% for women vs. 4.4% for men, p=0.019). The plasma concentration of ADMA in the RAS group was significantly higher than that in the control group [22.1 ng/mL (12.1–37.8) vs. 9.2 ng/mL (5.9–14.8), p<0.001]. Moreover, the plasma concentration of ADMA was significantly higher in patients with RAS among female patients [20.4 ng/mL (12.1–44.9) vs. 9.9 ng/mL (6.2–16.6); p=0.002] and among male patients [25.2 ng/mL (13.7–35.4) vs. 8.2 ng/mL (5.9–12.8); p=0.007]. Binary logistic regression analysis of all patients showed that ADMA concentration was the only predictor for RAS (odds ratio=1.142; 95% confidence interval=1.061–1.228; p<0.001). Conclusion: It was found that the ADMA concentration of the patients in the RAS group was elevated compared to that of controls. The findings indicated that elevated ADMA concentrations could predict RAS that may occur. (Anatol J Cardiol 2020; 23: 228-32)

The relationship between radial artery spasm and adropin levels in patients undergoing transradial coronary angiography

“… 6 , 7 Moreover, a decrease in the NO levels, which is a vasoactive substance produced from the endothelium and plays an important role in vascular tonus, seems to be associated with RAS occurrence in patients undergoing TRA procedures. 13 Adropin increases the release of NO by increasing eNOS activity, causes vasodilation in the vessel wall with an indirect effect and has a potential endothelial protective role. Adropin plays a protective role against endothelial dysfunction by regulating eNOS expression through various growth factors and proteins.…”

ADMA mediates gastric cancer cell migration and invasion via Wnt/β-catenin signaling pathway

“…Some studies in pheochromocytoma cells have suggested that ADMA can reduce the glutamate-induced cytotoxicity, apoptosis and Caspase-3 activation and reverse the down-regulation of glutamate-induced bcl-2 expression [ 16 ]. Also, it has been reported that ADMA levels may be increased in non-oncologic processes such as radial artery spasm, coronary artery disease and so on [ 17 , 18 ]. Although, ADMA plays a significant role in promoting tumor progression in colon cancer and esophageal cancer, the role of ADMA in gastric cancer has not been well investigated.…”