ADMA in coronary artery disease

IIn a nested case-control study from Finland, clinically healthy, non-smoking men whose ADMA levels were in the highest quartile of the distribution had a significant, almost 4-fold elevation of the risk of developing major adverse cardiovascular events as compared to those in the lowest quartile [37]. In the large, multicenter CARDIAC study from Germany (Coronary Artery Risk Determination evaluating the Influence of ADMA Concentration) including more than 400 patients with coronary artery disease and more than 400 control subjects, patients were found to have significantly higher ADMA levels than healthy age- and sex-matched controls. In this study, ADMA was found to be an independent risk marker for the presence of coronary artery disease [38].
In the latter study ADMA levels increased with increasing number of traditional cardiovascular risk factors (Figure 12a). In a multivariate statistical analysis including other risk factors, ADMA levels above 1.7 µmol/l were found to be indicative for identification of a person as having CAD [38].

These data suggest that ADMA is a risk marker for coronary artery disease that provides information beyond currently established risk indicators.

Figure 12. ADMA plasma levels as a function of the number of traditional risk factors present (a). With increasing ADMA concentration the probability increases that a given patient suffers from coronary artery disease (b; data from [38]).