Could plasma asymmetric dimethylarginine level be a novel predictor beyond the classic predictors of stent restenosis?

Abstract

Objective: The aim of this study was to investigate the factors associated with coronary stent restenosis and if there is an association betweenplasma asymmetric dimethylarginine (ADMA) levels and stent restenosis.Methods: Ninety-one patients, who had a history of coronary bare metal stent implantation due to any cause in the last one year period, wereadmitted to this observational cross-sectional study. Coronary angiography was performed to all patients and quantitative angiography wasused to determine the presence of stent restenosis. Laboratory parameters and angiographic features that contribute to stent restenosis wereevaluated. Plasma ADMA levels were measured by using high performance liquid chromatography. Logistic regression analysis was used todetermine the independent factors of stent restenosis.Results: Angiographic restenosis was found in 35 patients (38.5%). Stent diameter (p=0.038) and left ventricular ejection fraction (p=0.023) werelower and stent implantation history due to acute coronary syndrome (p=0.029), plasma ADMA level (5.0±1.8x10 -4 mmol/L vs. 3.9±1.0x10 -4mmol/L, p=0.001), C-reactive protein concentration (p=0.016), white blood cell count (p=0.044) and stent length (p=0.005) were higher in patientswith restenosis. Plasma ADMA level ( β=0.536; OR: 1.710; CI: 1.022-2.861; p=0.041), C-reactive protein concentration (β=0.062; OR: 1.064; CI: 1.003-1.129; p=0.041), stent diameter ( β=-3.047; OR: 0.048; CI: 0.007-0.313; p=0.002) and length ( β=0.165; OR: 1.179; CI: 1.036-1.343; p=0.013) were foundto be the independent predictors of stent restenosis in logistic regression analysis.Conclusion: We conclude that plasma ADMA levels may be used as a novel marker for stent restenosis beyond the classic stent restenosismarkers.