Low homoarginine concentration is a novel risk factor for heart disease

BackgroundHomoarginine is an amino acid which may play a role in nitric oxide and energy metabolism. Low homoarginine concentrations have previously been linked to increased mortality, but the underlying mechanisms remain unknown.ObjectivesTo investigate whether serum homoarginine concentrations are associated with myocardial function, energy metabolism and fatal events.Design and patientsSerum homoarginine concentrations were measured in 3305 Caucasian patients who were referred for coronary angiography at a tertiary care centre in Germany. After baseline examinations (1997–2000), patients were followed-up with respect to specific causes of death.ResultsHomoarginine concentration correlated positively with angiographic ejection fraction and was inversely associated with N-terminal pro-B-type natriuretic peptide (p