Abstract 14456: Incidence of All-cause and Cardiovascular Mortality Predicted by Symmetric Dimethylarginine in the Population-based Study of Health in Pomerania
Aims: Arginine derivatives like asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and homoarginine have been associated with cardiovascular and all-cause mortality in populations at risk. We investigated the prognostic value of these arginine derivatives in the general population.
Methods and results: We evaluated 3,952 individuals (1,936 men and 2,016 women) aged 20-81 (mean 51 years) from the population-based Study of Health in Pomerania (SHIP). Associations of continuous [per standard deviation (SD) increase] and categorized (age- and sex-specific 10th and 90th percentile) plasma arginine, ADMA, SDMA, and homoarginine concentrations with all-cause and cause-specific mortality were analysed. During a median follow-up period of 10.1 years (38,476 person-years), 426 deaths (10.8%), 139 cardiovascular deaths (3.5%), and 150 cancer deaths (3.8%) were observed. After multivariable adjustment, we revealed a positive association of SDMA with all-cause mortality [hazard ratio (HR) per SD increase: 1.16, 95% confidence interval (CI): 1.07-1.25] and cardiovascular mortality [HR: 1.19, 95% CI: 1.05-1.35]. In contrast, we did not observe any association of SDMA with cancer mortality. Among the other markers, only homarginine was associated only with all-cause mortality [HR: 0.87, 95% CI: 0.78-0.97].
Conclusion: SDMA, but not ADMA, is an independent predictor of all-cause and cardiovascular mortality in a large population-based cohort of European ancestry.
Figure: Kaplan-Meier Curves for plasma SDMA for (A) all-cause and (B) CV mortality.
- © 2013 by American Heart Association, Inc.