Should We Measure Asymmetric Dimethylarginine in Patients with Coronary Artery Disease?
In this issue of Clinical Chemistry, Meinitzer et al. (1) present data from The Ludwigshafen Risk and Cardiovascular Health Study in which they assess asymmetric dimethylarginine (ADMA) as a cardiovascular biomarker in 3238 patients. Coronary angiography identified 2543 patients with coronary artery disease as well as 695 persons without significant disease. Study participants were followed for more than 5 years. The major finding of the study was that plasma ADMA was an independent predictor of total and cardiovascular mortality. What Is ADMA? ADMA is a naturally occurring amino acid that has the interesting property of competitively inhibiting the activity of nitric oxide synthase (NOS). ADMA is produced by methylation of arginine residues in intracellular proteins via protein arginine N-methyltransferases (PRMT). When these proteins are hydrolyzed, ADMA is released. ADMA is excreted in the urine, and, not surprisingly, plasma ADMA is increased in patients with end-stage renal diseas
