Symmetrical dimethylarginine predicts mortality in the general population: Observations from the dallas heart study

M. Odette Gore, Nicole Lüneburg, Edzard Schwedhelm, Colby R. Ayers, Maike Anderssohn, Amit Khera, Dorothee Atzler, James A de Lemos, Peter J. Grant, Darren K McGuire, Rainer H. Böger

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


OBJECTIVE-: Increased asymmetrical dimethylarginine (ADMA), a NO synthase inhibitor, and its congener symmetrical dimethylarginine (SDMA), predict cardiovascular and all-cause mortality in at-risk populations. Their prognostic value in the general population remains uncertain. We investigated the correlations of SDMA and ADMA with atherosclerosis and cardiovascular/all-cause mortality in the Dallas Heart Study, a multiethnic probability-based cohort aged 30 to 65 years. APPROACH AND RESULTS-: SDMA and ADMA were measured by liquid chromatography-tandem mass-spectrometry (n=3523), coronary artery calcium by electron-beam computed tomography, and abdominal aortic wall thickness by MRI. In unadjusted analyses, categories of increasing SDMA and ADMA were associated with higher prevalence of cardiovascular risk factors, increased risk markers, and all-cause and cardiovascular mortality (median follow-up, 7.4 years). After adjustment for age, sex, and race, traditional cardiovascular risk factors, and renal function, SDMA and ADMA analyzed as continuous variables were associated with coronary artery calcium >10, but only SDMA was associated with abdominal aortic wall thickness. SDMA, but not ADMA, was associated with cardiovascular mortality (hazard ratio per log unit change, 3.36 [95% confidence interval, 1.49-7.59]; P=0.004). SDMA and ADMA were both associated with all-cause mortality, but after further adjustment for N-terminal pro-brain-type natriuretic peptide, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin T, only SDMA was associated with all-cause mortality (hazard ratio per log unit change, 1.86 [95% confidence interval, 1.04-3.30]; P=0.01). CONCLUSIONS-: SDMA, but not ADMA, was an independent predictor of all-cause and cardiovascular mortality in a large multiethnic population-based cohort.

Original languageEnglish (US)
Pages (from-to)2682-2688
Number of pages7
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number11
StatePublished - Nov 2013


  • atherosclerosis
  • mortality
  • population
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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