الفهرس 
Acute Coronary SyndromeOnly 14 pages are availabe for public view
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Abstract
Background: Atherosclerosis is the primary cause of acute coronary syndrome, with most cases occurring from the disruption of atherosclerotic plaque in a coronary artery stimulating platelet aggregation and thrombus formation .Asymmetric dimethylarginine (ADMA) is a naturally occurring chemical found in blood plasma. It is a metabolic by-product of continual protein modification processes in the cytoplasm of all human cells. ADMA inhibits the three isoforms of nitric oxide. It can also generate superoxides, and it interfaces with other targets in the cell. High ADMA values inhibit nitric oxide production needed to promote vasodilation.
Aim of the work: Determining the value of the asymmetric dimethylarginine in patients with acute coronary syndrome as a predictor of major adverse cardiac events (MACE) & mortalilty during hospitalization & up to 6 months.
Patients & Methods: This study included 90 patients who were admitted to the cardiac care unit in Ain shams university hospitals with acute coronary syndrome. The patients received optimum medical therapy, in addition, they underwent coronary angiography with either primary or facilitated percutaneous coronary intervention (PCI). Full labs with ADMA marker were obtained within 24 hours of admission, then follow up during hospitalization & up to 6 months after discharge was done regarding the occurrence of major adverse cardiac events (MACE) &mortality. The patients were divided into three groups (A, B & C) according to their admission value of ADMA. Thirteen patients were unreachable during follow up, so seventy seven patients only were included in the study results.
Results: The study population consisted of seventy seven patients ( eleven patients were lost during follow up) with an age ranged from 29 yrs to 85 yrs. The mean age in years was 55.26±9.09. It included sixteen females (20.8%) and sixty one males (79.2%). There was statistical significance between ADMA &LDL, HDL& total cholesterol. Also there is statistical significance between ADMA marker &the prognosis & between the patient`s groups & the prognosis. The cut off value of ADMA marker is >1.2
Conclusion: Asymmetric dimethyl arginine ( ADMA) marker has a prognostic value in patients with acute coronary syndrome , in which patients with higher levels of ADMA are associated with higher incidence of MACE & higher mortality than patients with low levels of ADMA.