SDMA is a marker of detrimental outcome in the acute phase after ischemic stroke: Role of renal function

Nicole Lüneburg (1) , Rouven Alexander von Holten , Rudolf F Töpper , Edzard Schwedhelm , Renke Maas , Rainer H Böger

1 Department of Clinical Pharmacology and Toxicology

Methylarginines have been shown to interfere with nitric oxide (NO) formation by inhibiting NO synthase (asymmetric dimethylarginine, ADMA) and cellular L-arginine uptake into the cell (ADMA, and symmetric dimethylarginine, SDMA). In a recent study elevation of SDMA was related to long term mortality in patient recruited 30 days after a stroke event. In the present study we aimed to investigate the association of SDMA and adverse clinical outcome in the early phase (first 30 days) after acute ischemic stroke. 137 patients were recruited immediately upon admission to the emergency unit with an acute ischemic stroke. Plasma levels of methylarginines were determined by a validated LC/MS-MS method. Patients were prospectively followed for 30 days. 25 patients (18.2 %) experienced the primary composite endpoint (death, recurrent stroke, MI, rehospitalisation). SDMA plasma levels were significantly higher in patients with compared to patients without event (0.89±0.80 vs. 0.51±0.24 µmol/l; p<0.001). SDMA levels were significantly correlated with markers of renal function. Kaplan-Meier survival analysis demonstrated that cumulative survival decreased significantly with ascending tertiles of SDMA (p<0.001). Our study provides first data indicating that SDMA is strongly associated with adverse clinical outcome during the first 30 days after ischemic stroke. Our results strengthen the prognostic value of renal function in patients with stroke and confirms the hypothesis that SDMA is a promising marker for renal function.

Mots clés: Medicine

Domaines: Médecine humaine et pathologie

Nicole Lüneburg, Rouven Alexander von Holten, Rudolf F Töpper, Edzard Schwedhelm, Renke Maas, et al.. SDMA is a marker of detrimental outcome in the acute phase after ischemic stroke: Role of renal function. Clinical Science, 2011, 122 (3), pp.105-111. ⟨10.1042/CS20110013⟩. ⟨hal-00735847⟩