Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial
(1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital...
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| Veröffentlicht in: | Journal of clinical medicine 2020-11, Vol.9 (12), p.3815 |
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| creator | Keller, Annalena Becker, Christoph Nienhaus, Katharina Beck, Katharina Vincent, Alessia Sutter, Raoul Tisljar, Kai Schuetz, Philipp Bernasconi, Luca Neyer, Peter Pargger, Hans Marsch, Stephan Hunziker, Sabina |
| description | (1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital cardiac arrest (OHCA) remains unclear. (2) Methods: We prospectively included OHCA patients, recorded clinical parameters and measured plasma ADMA, SDMA and Arginine levels by liquid chromatography tandem mass spectrometry (LC-MS). The primary endpoint was 90-day mortality. (3) Results: Of 263 patients, 130 (49.4%) died within 90 days after OHCA. Compared to survivors, non-survivors had significantly higher levels of ADMA and lower Arginine and Arginine/ADMA ratios in univariable regression analyses. Arginine levels and Arginine/ADMA ratio were significantly associated with 90-day mortality (OR 0.51 (95%CI 0.34 to 0.76),
< 0.01 and OR 0.40 (95%CI 0.26 to 0.61),
< 0.001, respectively). These associations remained significant in several multivariable models. Arginine/ADMA ratio had the highest predictive value with an area under the curve (AUC) of 0.67 for 90-day mortality. Results for secondary outcomes were similar with significant associations with in-hospital mortality and neurological outcome. (4) Conclusion: Arginine and Arginine/ADMA ratio were independently associated with 90-day mortality and other adverse outcomes in patients after OHCA. Whether therapeutic modification of the L-arginine-nitric oxide pathway has the potential to improve outcome should be evaluated. |
| doi_str_mv | 10.3390/jcm9123815 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7760544</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2466033446</sourcerecordid><originalsourceid>FETCH-LOGICAL-c406t-3eaa9350e28eab21d1c9cb7d4a389a0c698ff64ccb5c11cb9b5a114eaab5e2683</originalsourceid><addsrcrecordid>eNpdks1u1DAUhS0EolXphgdAltggRKj_k2yQRtNCkTpMVU3XluPcdDxK4sF2Bs0T8Zp41B8K3tiWv3t8jn0RekvJZ85rcraxQ00Zr6h8gY4ZKcuC8Iq_fLY-QqcxbkgeVSUYLV-jI86ZlKVkx-j3LNy50Y2Azdjix83Z7HwxwzcmOY-vA7TOJlyT4tzs8cKHZHqX9tiN-DoTMKaIf7m0xsspFb4rLn3cuszguQmtMzarBoipuIE49Zntgh9wWkNWziTY5HbwCS-bCGF3uHE8lC4Xi9sf3-ez1QVeBWf6N-hVZ_oIpw_zCbr9erGaXxZXy28ZuyqsICoVHIypuSTAKjANoy21tW3KVhhe1YZYVVddp4S1jbSU2qZupKFU5KpGAlMVP0Ff7nW3UzNAa3O6YHq9DW4wYa-9cfrfk9Gt9Z3f6bJURAqRBT48CAT_c8q59eCihb43I_gpaiaUIpwLoTL6_j9046eQ42dKCUqUouTg6OM9ZfNzxQDdkxlK9KEF9N8WyPC75_af0McP538AyG2uAQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2641066108</pqid></control><display><type>article</type><title>Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Keller, Annalena ; Becker, Christoph ; Nienhaus, Katharina ; Beck, Katharina ; Vincent, Alessia ; Sutter, Raoul ; Tisljar, Kai ; Schuetz, Philipp ; Bernasconi, Luca ; Neyer, Peter ; Pargger, Hans ; Marsch, Stephan ; Hunziker, Sabina</creator><creatorcontrib>Keller, Annalena ; Becker, Christoph ; Nienhaus, Katharina ; Beck, Katharina ; Vincent, Alessia ; Sutter, Raoul ; Tisljar, Kai ; Schuetz, Philipp ; Bernasconi, Luca ; Neyer, Peter ; Pargger, Hans ; Marsch, Stephan ; Hunziker, Sabina</creatorcontrib><description>(1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital cardiac arrest (OHCA) remains unclear. (2) Methods: We prospectively included OHCA patients, recorded clinical parameters and measured plasma ADMA, SDMA and Arginine levels by liquid chromatography tandem mass spectrometry (LC-MS). The primary endpoint was 90-day mortality. (3) Results: Of 263 patients, 130 (49.4%) died within 90 days after OHCA. Compared to survivors, non-survivors had significantly higher levels of ADMA and lower Arginine and Arginine/ADMA ratios in univariable regression analyses. Arginine levels and Arginine/ADMA ratio were significantly associated with 90-day mortality (OR 0.51 (95%CI 0.34 to 0.76),
< 0.01 and OR 0.40 (95%CI 0.26 to 0.61),
< 0.001, respectively). These associations remained significant in several multivariable models. Arginine/ADMA ratio had the highest predictive value with an area under the curve (AUC) of 0.67 for 90-day mortality. Results for secondary outcomes were similar with significant associations with in-hospital mortality and neurological outcome. (4) Conclusion: Arginine and Arginine/ADMA ratio were independently associated with 90-day mortality and other adverse outcomes in patients after OHCA. Whether therapeutic modification of the L-arginine-nitric oxide pathway has the potential to improve outcome should be evaluated.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9123815</identifier><identifier>PMID: 33255752</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Biomarkers ; Blood ; Cardiac arrest ; Cardiopulmonary resuscitation ; Cardiovascular disease ; Chronic obstructive pulmonary disease ; Clinical medicine ; Coronary vessels ; CPR ; Diabetes ; Hospitals ; Hypertension ; Intensive care ; Kidney diseases ; Metabolites ; Mortality ; Patients ; Vein & artery diseases</subject><ispartof>Journal of clinical medicine, 2020-11, Vol.9 (12), p.3815</ispartof><rights>2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-3eaa9350e28eab21d1c9cb7d4a389a0c698ff64ccb5c11cb9b5a114eaab5e2683</citedby><cites>FETCH-LOGICAL-c406t-3eaa9350e28eab21d1c9cb7d4a389a0c698ff64ccb5c11cb9b5a114eaab5e2683</cites><orcidid>0000-0002-8682-9578 ; 0000-0002-4095-2765 ; 0000-0002-6575-356X ; 0000-0002-6909-6210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760544/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760544/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33255752$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keller, Annalena</creatorcontrib><creatorcontrib>Becker, Christoph</creatorcontrib><creatorcontrib>Nienhaus, Katharina</creatorcontrib><creatorcontrib>Beck, Katharina</creatorcontrib><creatorcontrib>Vincent, Alessia</creatorcontrib><creatorcontrib>Sutter, Raoul</creatorcontrib><creatorcontrib>Tisljar, Kai</creatorcontrib><creatorcontrib>Schuetz, Philipp</creatorcontrib><creatorcontrib>Bernasconi, Luca</creatorcontrib><creatorcontrib>Neyer, Peter</creatorcontrib><creatorcontrib>Pargger, Hans</creatorcontrib><creatorcontrib>Marsch, Stephan</creatorcontrib><creatorcontrib>Hunziker, Sabina</creatorcontrib><title>Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>(1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital cardiac arrest (OHCA) remains unclear. (2) Methods: We prospectively included OHCA patients, recorded clinical parameters and measured plasma ADMA, SDMA and Arginine levels by liquid chromatography tandem mass spectrometry (LC-MS). The primary endpoint was 90-day mortality. (3) Results: Of 263 patients, 130 (49.4%) died within 90 days after OHCA. Compared to survivors, non-survivors had significantly higher levels of ADMA and lower Arginine and Arginine/ADMA ratios in univariable regression analyses. Arginine levels and Arginine/ADMA ratio were significantly associated with 90-day mortality (OR 0.51 (95%CI 0.34 to 0.76),
< 0.01 and OR 0.40 (95%CI 0.26 to 0.61),
< 0.001, respectively). These associations remained significant in several multivariable models. Arginine/ADMA ratio had the highest predictive value with an area under the curve (AUC) of 0.67 for 90-day mortality. Results for secondary outcomes were similar with significant associations with in-hospital mortality and neurological outcome. (4) Conclusion: Arginine and Arginine/ADMA ratio were independently associated with 90-day mortality and other adverse outcomes in patients after OHCA. Whether therapeutic modification of the L-arginine-nitric oxide pathway has the potential to improve outcome should be evaluated.</description><subject>Age</subject><subject>Biomarkers</subject><subject>Blood</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical medicine</subject><subject>Coronary vessels</subject><subject>CPR</subject><subject>Diabetes</subject><subject>Hospitals</subject><subject>Hypertension</subject><subject>Intensive care</subject><subject>Kidney diseases</subject><subject>Metabolites</subject><subject>Mortality</subject><subject>Patients</subject><subject>Vein & artery diseases</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdks1u1DAUhS0EolXphgdAltggRKj_k2yQRtNCkTpMVU3XluPcdDxK4sF2Bs0T8Zp41B8K3tiWv3t8jn0RekvJZ85rcraxQ00Zr6h8gY4ZKcuC8Iq_fLY-QqcxbkgeVSUYLV-jI86ZlKVkx-j3LNy50Y2Azdjix83Z7HwxwzcmOY-vA7TOJlyT4tzs8cKHZHqX9tiN-DoTMKaIf7m0xsspFb4rLn3cuszguQmtMzarBoipuIE49Zntgh9wWkNWziTY5HbwCS-bCGF3uHE8lC4Xi9sf3-ez1QVeBWf6N-hVZ_oIpw_zCbr9erGaXxZXy28ZuyqsICoVHIypuSTAKjANoy21tW3KVhhe1YZYVVddp4S1jbSU2qZupKFU5KpGAlMVP0Ff7nW3UzNAa3O6YHq9DW4wYa-9cfrfk9Gt9Z3f6bJURAqRBT48CAT_c8q59eCihb43I_gpaiaUIpwLoTL6_j9046eQ42dKCUqUouTg6OM9ZfNzxQDdkxlK9KEF9N8WyPC75_af0McP538AyG2uAQ</recordid><startdate>20201125</startdate><enddate>20201125</enddate><creator>Keller, Annalena</creator><creator>Becker, Christoph</creator><creator>Nienhaus, Katharina</creator><creator>Beck, Katharina</creator><creator>Vincent, Alessia</creator><creator>Sutter, Raoul</creator><creator>Tisljar, Kai</creator><creator>Schuetz, Philipp</creator><creator>Bernasconi, Luca</creator><creator>Neyer, Peter</creator><creator>Pargger, Hans</creator><creator>Marsch, Stephan</creator><creator>Hunziker, Sabina</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8682-9578</orcidid><orcidid>https://orcid.org/0000-0002-4095-2765</orcidid><orcidid>https://orcid.org/0000-0002-6575-356X</orcidid><orcidid>https://orcid.org/0000-0002-6909-6210</orcidid></search><sort><creationdate>20201125</creationdate><title>Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial</title><author>Keller, Annalena ; Becker, Christoph ; Nienhaus, Katharina ; Beck, Katharina ; Vincent, Alessia ; Sutter, Raoul ; Tisljar, Kai ; Schuetz, Philipp ; Bernasconi, Luca ; Neyer, Peter ; Pargger, Hans ; Marsch, Stephan ; Hunziker, Sabina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-3eaa9350e28eab21d1c9cb7d4a389a0c698ff64ccb5c11cb9b5a114eaab5e2683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Biomarkers</topic><topic>Blood</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiovascular disease</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Clinical medicine</topic><topic>Coronary vessels</topic><topic>CPR</topic><topic>Diabetes</topic><topic>Hospitals</topic><topic>Hypertension</topic><topic>Intensive care</topic><topic>Kidney diseases</topic><topic>Metabolites</topic><topic>Mortality</topic><topic>Patients</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keller, Annalena</creatorcontrib><creatorcontrib>Becker, Christoph</creatorcontrib><creatorcontrib>Nienhaus, Katharina</creatorcontrib><creatorcontrib>Beck, Katharina</creatorcontrib><creatorcontrib>Vincent, Alessia</creatorcontrib><creatorcontrib>Sutter, Raoul</creatorcontrib><creatorcontrib>Tisljar, Kai</creatorcontrib><creatorcontrib>Schuetz, Philipp</creatorcontrib><creatorcontrib>Bernasconi, Luca</creatorcontrib><creatorcontrib>Neyer, Peter</creatorcontrib><creatorcontrib>Pargger, Hans</creatorcontrib><creatorcontrib>Marsch, Stephan</creatorcontrib><creatorcontrib>Hunziker, Sabina</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keller, Annalena</au><au>Becker, Christoph</au><au>Nienhaus, Katharina</au><au>Beck, Katharina</au><au>Vincent, Alessia</au><au>Sutter, Raoul</au><au>Tisljar, Kai</au><au>Schuetz, Philipp</au><au>Bernasconi, Luca</au><au>Neyer, Peter</au><au>Pargger, Hans</au><au>Marsch, Stephan</au><au>Hunziker, Sabina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2020-11-25</date><risdate>2020</risdate><volume>9</volume><issue>12</issue><spage>3815</spage><pages>3815-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>(1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital cardiac arrest (OHCA) remains unclear. (2) Methods: We prospectively included OHCA patients, recorded clinical parameters and measured plasma ADMA, SDMA and Arginine levels by liquid chromatography tandem mass spectrometry (LC-MS). The primary endpoint was 90-day mortality. (3) Results: Of 263 patients, 130 (49.4%) died within 90 days after OHCA. Compared to survivors, non-survivors had significantly higher levels of ADMA and lower Arginine and Arginine/ADMA ratios in univariable regression analyses. Arginine levels and Arginine/ADMA ratio were significantly associated with 90-day mortality (OR 0.51 (95%CI 0.34 to 0.76),
< 0.01 and OR 0.40 (95%CI 0.26 to 0.61),
< 0.001, respectively). These associations remained significant in several multivariable models. Arginine/ADMA ratio had the highest predictive value with an area under the curve (AUC) of 0.67 for 90-day mortality. Results for secondary outcomes were similar with significant associations with in-hospital mortality and neurological outcome. (4) Conclusion: Arginine and Arginine/ADMA ratio were independently associated with 90-day mortality and other adverse outcomes in patients after OHCA. Whether therapeutic modification of the L-arginine-nitric oxide pathway has the potential to improve outcome should be evaluated.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33255752</pmid><doi>10.3390/jcm9123815</doi><orcidid>https://orcid.org/0000-0002-8682-9578</orcidid><orcidid>https://orcid.org/0000-0002-4095-2765</orcidid><orcidid>https://orcid.org/0000-0002-6575-356X</orcidid><orcidid>https://orcid.org/0000-0002-6909-6210</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical medicine, 2020-11, Vol.9 (12), p.3815 |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Age Biomarkers Blood Cardiac arrest Cardiopulmonary resuscitation Cardiovascular disease Chronic obstructive pulmonary disease Clinical medicine Coronary vessels CPR Diabetes Hospitals Hypertension Intensive care Kidney diseases Metabolites Mortality Patients Vein & artery diseases |
| title | Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial |
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