Asymmetric dimethylarginine (ADMA) and hyperhomocysteinemia in patients with acute myocardial infarction

Objectives: We sought to investigate the association between increased levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, and total plasma homocysteinemia (tHcy) in patients with acute myocardial infarction (AMI). Design and methods: In 138 patients hospitalized for AMI < 24 h on admission, serum levels of ADMA, its symmetric stereoisomer (SDMA) and tHcy were measured. Results: ADMA was positively associated with SDMA (p < 0.001) and tHcy (p = 0.03) but not with estimated glomerular filtration rates (eGFR, p = 0.96), while tHcy strongly correlated with eGFR (p = 0.002) and SDMA (p < 0.001). By multiple linear regression, SDMA but not ADMA was independently associated with tHcy (p = 0.005). Conclusion: Our findings suggest that, in AMI patients, hyperhomocysteinemia is indirectly related to ADMA levels via renal function. Moreover, ADMA level was independent of traditional cardiovascular risk factors in AMI patients. Interestingly, our findings suggest that SDMA could be a good risk indicator for cardiovascular disease in AMI patients.