Serum concentrations of l-arginine and l-homoarginine in male patients with intermittent claudication: A cross-sectional and prospective investigation in the CAVASIC Study. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Vogl, Lena; Pohlhammer, Johannes; Meinitzer, Andreas; Rantner, Barbara; Stadler, Marietta; Peric, Slobodan; Hammerer-Lercher, Angelika; Klein-Weigel, Peter; Fraedrich, Gustav; Kronenberg, Florian; Kollerits, Barbara
• Is Part Of: Atherosclerosis. Volume 239:Issue 2(2015)
• Page Start: 607
• Page End: 614
• Publication Date: 2015-04
• Subjects: Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.02.019
• Languages: English
• ISSNs: 0021-9150

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">High serum concentrations of <sc>l</sc>-arginine and <sc>l</sc>-homoarginine increase nitric oxide (NO) availability and thereby improve endothelial function. Information about the association of these markers with peripheral arterial disease (PAD) and related outcomes is sparse.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015"> <sc>l</sc>-arginine, its metabolites and <sc>l</sc>-homoarginine were analyzed in the CAVASIC Study including 232 male patients diagnosed with intermittent claudication and 246 age- and diabetes-matched controls. After the baseline investigation PAD patients were prospectively followed (median 7 years). The association of these markers with symptomatic PAD at baseline, incident cardiovascular events and all-cause mortality was assessed.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">At baseline each increase of ln-<sc>l</sc>-homoarginine and <sc>l</sc>-arginine by one standard deviation was associated with symptomatic PAD: OR = 0.75, 95%CI 0.59–0.96, P = 0.02 and OR = 1.36, 95%CI 1.07–1.73, P = 0.01, respectively (both models adjusted for ln-CRP, GFR, HDL cholesterol, and current smoking). Only <sc>l</sc>-arginine remained significant after additional adjustment for ln-NT-proBNP and hs-cTnT: OR = 1.49, P = 0.002. In the Cox regression analysis elevated ln-<sc>l</sc>-homoarginine significantly reduced the risk to die (n = 38) even independent from ln-NT-proBNP and hs-cTnT: HR = 0.59, 95%CI 0.41–0.84, P = 0.004. <sc>l</sc>-arginine was significantly predicting incident cardiovascular events (n = 65): HR = 1.68, 95%CI 1.35–2.10, P < 0.001.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">This study in male patients with intermittent claudication and age- and diabetes-matched controls showed an association of <sc>l</sc>-homoarginine and <sc>l</sc>-arginine with PAD. During follow-up, <sc>l</sc>-arginine was associated with incident cardiovascular events probably due to its primary role in NO metabolism and impact on endothelial integrity. <sc>l</sc>-homoarginine was related to all-cause mortality implying a broader role in metabolic processes besides endothelial function.</p> </sec> </abstract>