TY  - JOUR
A1  - Atzler, Dorothee
A1  - Baum, Christina
A1  - Ojeda, Francisco
A1  - Keller, Till
A1  - Cordts, Kathrin
A1  - Schnabel, Renate B.
A1  - Choe, Chi‐un
A1  - Lackner, Karl Johannes
A1  - Münzel, Thomas
A1  - Böger, Rainer H.
A1  - Blankenberg, Stefan
A1  - Schwedhelm, Edzard
A1  - Zeller, Tanja
T1  - Low homoarginine levels in the prognosis of patients with acute chest pain
T2  - Journal of the American Heart Association
N2  - Background The endogenous amino acid homoarginine predicts mortality in cerebro‐ and cardiovascular disease. The objective was to explore whether homoarginine is associated with atrial fibrillation (AF) and outcome in patients with acute chest pain.
Methods and Results One thousand six hundred forty‐nine patients with acute chest pain were consecutively enrolled in this study, of whom 589 were diagnosed acute coronary syndrome (ACS). On admission, plasma concentrations of homoarginine as well as brain natriuretic peptide (BNP), and high‐sensitivity assayed troponin I (hsTnI) were determined along with electrocardiography (ECG) variables. During a median follow‐up of 183 days, 60 major adverse cardiovascular events (MACEs; 3.8%), including all‐cause death, myocardial infarction, or stroke, were registered in the overall study population and 43 MACEs (7.5%) in the ACS subgroup. Adjusted multivariable Cox regression analyses revealed that an increase of 1 SD of plasma log‐transformed homoarginine (0.37) was associated with a hazard reduction of 26% (hazard ratio [HR], 0.74; 95% CI, 0.57–0.96) for incident MACE and likewise of 35% (HR, 0.65; 95% CI, 0.49–0.88) in ACS patients. In Kaplan–Meier survival curves, homoarginine was predictive for patients with high‐sensitivity assayed troponin I (hsTnI) above 27 ng/L (P<0.05). Last, homoarginine was inversely associated with QTc duration (P<0.001) and prevalent AF (OR, 0.83; 95% CI, 0.71–0.95).
Conclusion Low plasma homoarginine was identified as a risk marker for incident MACEs in patients with acute chest pain, in particular, in those with elevated hsTnI. Impaired homoarginine was associated with prevalent AF. Further studies are needed to investigate the link to AF and evaluate homoarginine as a therapeutic option for these patients.
KW  - acute coronary syndrome
KW  - atrial fibrillation
KW  - homoarginine
KW  - l‐arginine:glycine amidinotransferase
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/40327
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-403277
N1  - This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License http://creativecommons.org/licenses/by-nc/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
VL  - 5
IS  - e002565
SP  - 1
EP  - 14
PB  - New York, NY
CY  - American Heart Association
ER  -