Guanidino compound ratios are associated with stroke etiology, internal carotid artery stenosis and CHA(2)DS(2)-VASc score in three cross-sectional studies

Cordts, Kathrin; Grzybowski, Ricarda; Lezius, Susanne; Lueneburg, Nicole; Atzler, Dorothee; Neu, Axel; Hornig, Soeke; Boeger, Rainer H.; Gerloff, Christian; Magnus, Tim; Thomalla, Götz; Schwedhelm, Edzard; Grant, Peter J. und Choe, Chi-un (2019): Guanidino compound ratios are associated with stroke etiology, internal carotid artery stenosis and CHA(2)DS(2)-VASc score in three cross-sectional studies. In: Journal of the Neurological Sciences, Bd. 397: S. 156-161

Abstract

Introduction: Guanidino compounds, including L-homoarginine (L-hArg), symmetric dimethylarginine (SDMA), asymmetric dimethylarginine (ADMA) and L-arginine (L-Arg) are associated with mortality, fatal strokes, stroke incidence, and atherosclerosis. Objectives: We aimed to study the association of guanidino compounds (L-hArg/ADMA and L-hArg/SDMA) with stroke etiology, internal carotid artery (ICA) stenosis and CHA(2)DS(2)-VASc score in patients with cerebrovascular disease. Methods: We analyzed L-hArg, SDMA, ADMA, L-Arg, and compound molar ratios, i.e. L-hArg/ADMA and L-hArg/SDMA, in 272 patients with cerebrovascular disease in a cross-sectional discovery cohort and two cross-sectional validation cohorts of acute stroke patients from Germany (n = 137) and UK (n = 394). The guanidino compound levels were compared with clinical, imaging, and ultrasound parameters. Results: Low L-hArg/ADMA and L-hArg/SDMA molar ratios predicted territorial infarcts (OR 1.74;95% CI 1.34-2.26 and OR 1.64;95% CI 1.26-2.15, respectively) and were associated with stroke subtypes due to large vessel disease or cardio-embolism (OR 1.52;95% CI 1.12-2.06 and OR 2.01;95% CI 1.35-3.00, respectively) in meta-analysis of the discovery and validation cohort data. In line with these results, a low L-hArg/ADMA and L-hArg/SDMA molar ratio was found in patients with ICA stenosis (OR 0.73;95% CI 0.55-0.97 and OR 0.69;95% CI 0.50-0.94, respectively) in the discovery and validation cohort. Furthermore, guanidino compound ratios (i.e. L-hArg/ADMA and L-11Arg/SDMA) were strongly correlated with CHA2DS2-VASC score (p <.001) in all three cohorts. Discussion: The results from these three cross-sectional studies reveal that guanidino compound ratios (i.e. L-hArg/ADMA and L-hArg/SDMA) can discriminate stroke etiologies, predict ICA stenosis and estimate risk prediction in patients with cerebrovascular disease.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0022-510X
• Sprache: Englisch