Asymmetrical dimethylarginine (ADMA) and coronary endothelial function in patients with coronary artery disease and mild hypercholesterolemia.

OBJECTIVE: To investigate the association of the endogenous nitric oxide synthase inhibitor asymmetrical dimethylarginine (ADMA) and coronary endothelial function. METHODS AND RESULTS: In 289 patients with coronary artery disease we assessed coronary endothelium-dependent and -independent vascular responses to intracoronary infusion of acetylcholine, adenosine, and nitroglycerin, respectively, and determined plasma ADMA and l-arginine concentrations by HPLC. After 6 months of treatment with either cerivastatin, nifedipine, cerivastatin+nifedipine, or placebo, coronary vascular function testing as well as ADMA and l-arginine determinations were repeated. We observed no correlation of plasma ADMA or l-arginine concentration and coronary response to acetylcholine, adenosine or nitroglycerin baseline, and no correlation of changes of ADMA or l-arginine plasma concentration with changes in coronary function (all r and rho<0.3, all p>0.05). CONCLUSION: At physiological plasma concentrations ADMA appears to have only little impact on coronary endothelial function.

[Homocysteine--risk factor or risk indicator?]. / B-Vitamine senken den Homocysteinspiegel. Sinkt damit auch das Risiko für Herzinfarkt und Schlaganfall?

Since many patients experience cardiovascular events despite the absence of such classical risk factors as hypertension, high blood lipid levels, diabetes or smoking, the search for the underlying causes of arteriosclerotic vascular disease is continuing. The data accumulated to date are by no means unequivocal. Although the intake of vitamin B6, B12 and folic acid is associated with a decrease in the homocysteine level, more recent studies have failed to detect any significant reduction in the cardiovascular risk of these patients. Consequently, screening for homocysteine would not appear to make good sense at the present time.