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

Abstract

Objective \nTo analyze the relationship between serum asymmetric dimethylarginine (ADMA) and initial acute coronary syndrome (ACS) after taking a proton pump inhibitor (PPI). \n \n \nMethods \nFrom 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. \n \n \nResults \nSerum 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 0.05). 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). \n \n \nConclusions \nSerum 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. \n \n \nKey words: \nAsymmetric dimethylarginine;\xa0Proton pump inhibitor;\xa0Acute coronary syndrome