Low homoarginine/SDMA ratio is associated with poor short- and long-term outcome after stroke in two prospective studies.
L-homoarginine
Modified Rankin Scale (mRS)
Mortality
NIHSS
Stroke
Symmetric dimethylarginine
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
03
04
2019
accepted:
28
08
2019
pubmed:
5
9
2019
medline:
13
11
2020
entrez:
5
9
2019
Statut:
ppublish
Résumé
Guanidino compounds, including asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-homoarginine (hArg), have been associated with cardio- and cerebrovascular events and risk. We aimed to study if low hArg/ADMA and hArg/SDMA ratios are associated with mortality and outcome after stroke. In two prospective cohorts of acute stroke patients from Germany and the UK, we analyzed hArg, ADMA, and SDMA to determine hArg/ADMA and hArg/SDMA ratios. The guanidino compound levels were associated with mortality, adverse events, and neurological impairment, i.e., National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). During 7.4 years, high hArg/ADMA and hArg/SDMA ratios were both associated with a reduction in all-cause mortality in patients with ischemic stroke in a UK stroke cohort (hArg/ADMA: hazard ratio (HR) 0.75 [95% confidence interval (CI) 0.62-0.92]; n = 394; P = 0.006; hArg/SDMA: HR 0.68 [0.54-0.85]; n = 394; P = 0.001). In a German stroke cohort, patients with high hArg/SDMA ratio experienced fewer adverse events compared with those with low hArg/SDMA ratios within 30 days after stroke (HR 0.73 [0.57-0.92]; n = 135; P = 0.009), whereas hArg/ADMA was not predictive. Furthermore, hArg/SDMA ratios inversely correlated with the degree of neurological impairment (NIHSS) (r = - 0.27; P = 0.001; n = 138). Lower hArg/SDMA ratios were also found in dependent (mRS 3-6) compared with independent patients (mRS < 3; P = 0.007; n = 138), whereas hArg/ADMA did not. These results from two prospective stroke studies reveal that hArg/SDMA ratio could prove a valuable blood-based biomarker to discriminate patients with poor short- and long-term outcome, increased neurological impairment, and severe disability after stroke.
Sections du résumé
BACKGROUND
BACKGROUND
Guanidino compounds, including asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-homoarginine (hArg), have been associated with cardio- and cerebrovascular events and risk. We aimed to study if low hArg/ADMA and hArg/SDMA ratios are associated with mortality and outcome after stroke.
METHODS
METHODS
In two prospective cohorts of acute stroke patients from Germany and the UK, we analyzed hArg, ADMA, and SDMA to determine hArg/ADMA and hArg/SDMA ratios. The guanidino compound levels were associated with mortality, adverse events, and neurological impairment, i.e., National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS).
RESULTS
RESULTS
During 7.4 years, high hArg/ADMA and hArg/SDMA ratios were both associated with a reduction in all-cause mortality in patients with ischemic stroke in a UK stroke cohort (hArg/ADMA: hazard ratio (HR) 0.75 [95% confidence interval (CI) 0.62-0.92]; n = 394; P = 0.006; hArg/SDMA: HR 0.68 [0.54-0.85]; n = 394; P = 0.001). In a German stroke cohort, patients with high hArg/SDMA ratio experienced fewer adverse events compared with those with low hArg/SDMA ratios within 30 days after stroke (HR 0.73 [0.57-0.92]; n = 135; P = 0.009), whereas hArg/ADMA was not predictive. Furthermore, hArg/SDMA ratios inversely correlated with the degree of neurological impairment (NIHSS) (r = - 0.27; P = 0.001; n = 138). Lower hArg/SDMA ratios were also found in dependent (mRS 3-6) compared with independent patients (mRS < 3; P = 0.007; n = 138), whereas hArg/ADMA did not.
CONCLUSION
CONCLUSIONS
These results from two prospective stroke studies reveal that hArg/SDMA ratio could prove a valuable blood-based biomarker to discriminate patients with poor short- and long-term outcome, increased neurological impairment, and severe disability after stroke.
Identifiants
pubmed: 31482247
doi: 10.1007/s10072-019-04058-0
pii: 10.1007/s10072-019-04058-0
doi:
Substances chimiques
Biomarkers
0
Homoarginine
156-86-5
symmetric dimethylarginine
49787G1ULV
Arginine
94ZLA3W45F
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
149-153Subventions
Organisme : Else Kröner-Fresenius-Stiftung (DE)
ID : 2018_EKES.04
Références
PLoS One. 2015 Jun 22;10(6):e0131293
pubmed: 26098562
Adv Clin Chem. 2009;48:73-94
pubmed: 19803415
Heart. 2011 Aug;97(15):1222-7
pubmed: 21558479
Circulation. 2013 Sep 24;128(13):1451-61
pubmed: 24004504
Clin Chim Acta. 2015 Feb 2;440:36-9
pubmed: 25444745
J Chromatogr B Analyt Technol Biomed Life Sci. 2007 May 15;851(1-2):211-9
pubmed: 17194630
Arch Biochem Biophys. 1994 Jul;312(1):31-7
pubmed: 8031143
J Neurol Sci. 2019 Feb 15;397:156-161
pubmed: 30640152
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Arterioscler Thromb Vasc Biol. 2013 Nov;33(11):2682-8
pubmed: 24008162
Int J Mol Sci. 2019 Feb 09;20(3):
pubmed: 30744089
J Am Soc Nephrol. 2006 Apr;17(4):1128-34
pubmed: 16481412
Cerebrovasc Dis. 2012;33(1):37-46
pubmed: 22133764
Circulation. 2010 Sep 7;122(10):967-75
pubmed: 20733103
Sci Rep. 2018 Sep 21;8(1):14197
pubmed: 30242192
Circ J. 2014;78(8):2094-5
pubmed: 24931514
Amino Acids. 2017 Jun;49(6):1111-1121
pubmed: 28285332
Arterioscler Thromb Vasc Biol. 2019 May;39(5):869-875
pubmed: 30866658
Clin Sci (Lond). 2012 Feb;122(3):105-11
pubmed: 21777201
Pharmacol Ther. 2007 Jun;114(3):295-306
pubmed: 17482266
Int J Cardiol. 2013 Sep 20;168(1):414-9
pubmed: 23073283