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Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial

Keller, Annalena and Becker, Christoph and Nienhaus, Katharina and Beck, Katharina and Vincent, Alessia and Sutter, Raoul and Tisljar, Kai and Schuetz, Philipp and Bernasconi, Luca and Neyer, Peter and Pargger, Hans and Marsch, Stephan and Hunziker, Sabina. (2020) Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial. Journal of clinical medicine, 9 (12). p. 3815.

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Official URL: https://edoc.unibas.ch/79513/

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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),; p; < 0.01 and OR 0.40 (95%CI 0.26 to 0.61),; p; < 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.
Faculties and Departments:03 Faculty of Medicine
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie
03 Faculty of Medicine > Departement Klinische Forschung
UniBasel Contributors:Sutter, Raoul Christian
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Multidisciplinary Digital Publishing Institute
ISSN:2077-0383
e-ISSN:2077-0383
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:29 Dec 2020 08:18
Deposited On:29 Dec 2020 08:18

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