Clinical Information

Asymmetric dimethylarginine (ADMA) is an independent risk factor for major adverse cardiovascular events.(1-7) ADMA inhibits nitric oxide (NO) synthesis and is elevated in diseases related to endothelial dysfunction including hypertension, hyperlipidemia, and type II diabetes mellitus. Elevation in ADMA and subsequent NO synthesis inhibition leads to vasoconstriction, reduced peripheral blood flow, and reduced cardiac output.

Elevated plasma ADMA confers a 4- to 6-fold increased risk of subsequent cardiovascular events or mortality among patients with acute coronary syndrome,(3) unstable angina,(4) type II diabetes mellitus,(5) end-stage renal disease,(6) coronary heart disease,(7) and peripheral artery disease.(1) Baseline ADMA remained a significant risk factor of adverse events even after adjusting for low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides, creatinine, and high-sensitivity C-reactive protein.

Plasma ADMA concentrations are lowered by rosuvastatin and atorvastatin, but not simvastatin in patients with hypercholesterolemia.(8) Addition of vildagliptin (Galvus) to metformin significantly reduced ADMA concentrations among patients with type II diabetes mellitus.(9)