Relationship between serum asymmetric dimethylarginine and initial acute coronary syndrome after taking a proton pump inhibitor

doi:10.3877/cma.j.issn.1674-0785.2019.06.004

Abstract

Abstract:

Objective

To analyze the relationship between serum asymmetric dimethylarginine (ADMA) and initial acute coronary syndrome (ACS) after taking a proton pump inhibitor (PPI).

Methods

From January 2017 to October 2018, we enrolled 140 patients with initial ACS and 70 healthy subjects. Among them, 70 patients were included in a PPI group (administration of PPI+ initial ACS), 70 patients in an ACS group (non-PPI+ initial ACS), and 70 healthy subjects (non-PPI+ non-ACS) in a control group. Serum ADMA concentration was measured by enzyme linked immunosorbent assay, and cholesterol and triglyceride were measured routinely. General demographic information, biochemical indicators, and ADMA levels were compared by one-way ANOVA, nonparametric test, and chi-square test. Mann-Whitney U test was used for comparison between groups. Spearman correlation analysis was used to analyze the relationship between serum ADMA level and traditional risk factors of acute coronary syndrome. Multivariate logistic regression analysis was used to investigate the risk factors for ACS.

Results

Serum ADMA levels in the PPI group and the ACS group were both significantly higher than that in the control group (Z=-9.585, -4.793, P<0.001). Serum ADMA level in the PPI group was significantly higher than that in the ACS group (Z=-8.750, P<0.001). Serum ADMA levels of ACS patients (PPI group and ACS group) were not correlated with age, gender, BMI, history of hypertension, history of diabetes, smoking history, TC, or TG (P>0.05). Logistic regression analysis showed that serum ADMA level was an independent risk factor for patients with initial ACS (β=0.017, OR=1.017, P<0.001).

Conclusions

Serum ADMA levels in patients with initial ACS after taking proton pump inhibitors are significantly higher than those in initial ACS patients without taking proton pump inhibitors. Serum ADMA levels in patients with initial ACS are significantly higher than those in healthy controls. Elevated serum ADMA is an independent risk factor for initial ACS.

Key words: Asymmetric dimethylarginine, Proton pump inhibitor, Acute coronary syndrome

Qianqian Chen, Li Ma, Chengyan Han, Changcheng Wang. Relationship between serum asymmetric dimethylarginine and initial acute coronary syndrome after taking a proton pump inhibitor[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(06): 424-428.

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Figures/Tables 3

References 17

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临床资料	PPI组（70例）	ACS组（70例）	对照组（70人）	统计值	P值
年龄（岁，±s）	62.80±11.87	62.66±12.13	62.96±9.09	F=0.332	0.847
男性［例（%）］	51（72.86）	55（78.57）	54（77.14）	χ²=0.900	0.638
BMI（kg/m²，±s）	25.03±2.56	24.32±2.92	24.24±3.18	F=4.016	0.134
糖尿病［例（%）］	19（27.14）	14（20.00）	11（13.33）	χ²=2.917	0.233
高血压［例（%）］	36（51.43）	42（60.00）	35（50.00）	χ²=2.250	0.325
吸烟［例（%）］	16（25.00）	17（24.29）	21（30.00）	χ²=0.577	0.749
TC［mmol/L，M（Q_R）］	4.92（3.72，5.80）	4.05（3.65，4.82）	4.54（3.24，5.00）	F=9.546	0.862
TG［mmol/L，M（Q_R）］	1.33（1.01，1.71）	1.42（1.02，1.88）	1.51（1.01，1.91）	F=1.880	0.391
ALT［U/L，M（Q_R）］	38（29，47）^c	39（32，56）^d	25（18，31）	F=51.011	<0.001
AST［U/L，M（Q_R）］	86（32，239）^e	122（67，211）^f	23（19，28）	F=95.011	<0.001
BUN［mmol/L，M（Q_R）］	5.77（4.69，6.86）	5.34（4.01，6.95）	5.30（4.48，6.27）	F=4.933	0.085
Scr［mmol/L，M（Q_R）］	79（68，93）	82（62，97）	75（65，81）	F=2.808	0.246
ADMA［nmol/L，M（Q_R）］	877.35（789.42，1028.64）^gh	646.88（614.97，695.39）ⁱ	587.07（523.21，643.30）	F=124.422	<0.001

临床资料	PPI组（70例）	ACS组（70例）	对照组（70人）	统计值	P值
年龄（岁，±s）	62.80±11.87	62.66±12.13	62.96±9.09	F=0.332	0.847
男性［例（%）］	51（72.86）	55（78.57）	54（77.14）	χ²=0.900	0.638
BMI（kg/m²，±s）	25.03±2.56	24.32±2.92	24.24±3.18	F=4.016	0.134
糖尿病［例（%）］	19（27.14）	14（20.00）	11（13.33）	χ²=2.917	0.233
高血压［例（%）］	36（51.43）	42（60.00）	35（50.00）	χ²=2.250	0.325
吸烟［例（%）］	16（25.00）	17（24.29）	21（30.00）	χ²=0.577	0.749
TC［mmol/L，M（Q_R）］	4.92（3.72，5.80）	4.05（3.65，4.82）	4.54（3.24，5.00）	F=9.546	0.862
TG［mmol/L，M（Q_R）］	1.33（1.01，1.71）	1.42（1.02，1.88）	1.51（1.01，1.91）	F=1.880	0.391
ALT［U/L，M（Q_R）］	38（29，47）^c	39（32，56）^d	25（18，31）	F=51.011	<0.001
AST［U/L，M（Q_R）］	86（32，239）^e	122（67，211）^f	23（19，28）	F=95.011	<0.001
BUN［mmol/L，M（Q_R）］	5.77（4.69，6.86）	5.34（4.01，6.95）	5.30（4.48，6.27）	F=4.933	0.085
Scr［mmol/L，M（Q_R）］	79（68，93）	82（62，97）	75（65，81）	F=2.808	0.246
ADMA［nmol/L，M（Q_R）］	877.35（789.42，1028.64）^gh	646.88（614.97，695.39）ⁱ	587.07（523.21，643.30）	F=124.422	<0.001

变量	r值	P值
年龄（岁）	0.052	0.543
性别	0.055	0.522
BMI（kg/m²）	0.156	0.066
吸烟（例）	0.119	0.161
高血压（例）	-0.022	0.796
糖尿病（例）	0.100	0.241
TC（mmol/L）	0.160	0.058
TG（mmol/L）	-0.094	0.267

变量	r值	P值
年龄（岁）	0.052	0.543
性别	0.055	0.522
BMI（kg/m²）	0.156	0.066
吸烟（例）	0.119	0.161
高血压（例）	-0.022	0.796
糖尿病（例）	0.100	0.241
TC（mmol/L）	0.160	0.058
TG（mmol/L）	-0.094	0.267

变量	β值	SE值	Wald值	P值	OR（95%CI）
年龄（岁）	-0.010	0.018	0.289	0.590	0.990（0.956~1.026）
性别	0.095	0.458	0.043	0.836	1.099（0.448~2.687）
BMI（kg/m²）	0.034	0.065	0.275	0.600	1.035（0.910~1.177）
高血压（例）	0.258	0.410	0.394	0.530	1.294（0.579~2.892）
糖尿病（例）	-0.487	0.561	0.754	0.385	0.614（0.204~1.846）
TC（mmol/L）	-0.090	0.166	0.298	0.585	0.914（0.660~1.264）
TG（mmol/L）	0.199	0.227	0.769	0.380	1.220（0.782~1.905）
ADMA（nmol/L）	0.017	0.003	35.242	<0.001	1.017（1.011~1.023）

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