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Turk Kardiyol Dern Ars. 2014 Dec;42(8):701-9. doi: 10.5543/tkda.2014.03272.

The association between coronary atherosclerotic burden and asymmetric dimethylarginine, carotis intima media thickness and endothelial function.

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Department of Cardiology, İstanbul Bilim University Faculty of Medicine, İstanbul, Turkey.
Department of Biochemistry, İstanbul Bilim University Faculty of Medicine, İstanbul, Turkey.
Department of Cardiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.



Detection of extent and severity of atherosclerosis using easy, non-invasive methods is of great importance. Atherosclerotic burden may be evaluated with the Gensini scoring system (GSS). Carotis intima media thickness (CIMT), plasma asymmetric dimethyl arginine (ADMA) level, and endothelial dysfunction are well known surrogate markers of atherosclerosis. The aim of this study was to evaluate the relationship between atherosclerotic burden determined by the GSS, and ADMA, CIMT and endothelial function.


Consecutive patients who had undergone coronary angiography were evaluated. 50 patients with acute coronary syndrome (ACS), 50 patients with stable coronary artery disease (SCA), and 50 patients with normal coronary arteries (NCA) were included. All subjects' GSS, ADMA, CIMT and endothelial functions were evaluated and compared.


GSS was higher in ACS than SCA (75.4 vs 54.9; p<0.001). CIMT was higher in ACS and SCA in compared to NCA (0.98, 0.96, 0.78 mm respectively; p<0.001). Endothelium derived vasodilatory response (EDVR) was decreased in ACS and SCA in compared to NCA (3.5±2.1%, 3.3±1.8%, 7.2±3.5% respectively; p<0.001). Plasma ADMA concentration was higher in ACS and SCA in compared to NCA (0.928, 0.992, 0.475 µmol/l respectively; p<0.001). There was a weak positive correlation between GSS and plasma ADMA levels (r=0.293; p=0.002), an intermediate positive correlation between GSS and CIMT (r=0.508; p<0.001), and an intermediate negative correlations between GSS and EDVR (r= -0.662; p<0.001).


This study showed that CIMT, ADMA concentration and endothelial dysfunction were significantly associated with CAD. However, only the GSS was significantly different between ACS and SCA groups.

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