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https://hdl.handle.net/2440/103108
Type: | Journal article |
Title: | The role of asymmetric dimethylarginine alone and in combination with N-terminal pro-B-type natriuretic peptide as a screening biomarker for systemic sclerosis-related pulmonary arterial hypertension: a case control study |
Author: | Thakkar, V. Stevens, W. Prior, D. Rabusa, C. Sahhar, J. G Walker, J. Roddy, J. Lester, S. Rischmueller, M. Zochling, J. Nash, P. Gabbay, E. Youssef, P. Proudman, S.M. Nikpour, M. |
Citation: | Clinical and Experimental Rheumatology, 2016; 34(5 (Suppl.100)):129-136 |
Publisher: | Pacini editore |
Issue Date: | 2016 |
ISSN: | 0392-856X 1593-098X |
Statement of Responsibility: | V. Thakkar, W. Stevens, D. Prior, C. Rabusa, J. Sahhar, J. Walker, J. Roddy, S. Lester, M. Rischmueller, J. Zochling, P. Nash, E. Gabbay, P. Youssef, S. Proudman, M. Nikpour |
Abstract: | OBJECTIVES: Asymmetric dimethylarginine (ADMA) is a novel biomarker of endothelial cell dysfunction. In this proof of concept study, we sought to evaluate the role of ADMA as a screening biomarker for incident systemic sclerosis-related pulmonary arterial hypertension (SSc-PAH). METHODS: ADMA levels were measured using high performance liquid chromatography in 15 consecutive treatment-naive patients with newly-diagnosed SSc-PAH and compared with 30 SSc-controls without PAH. Logistic regression models were used to evaluate the independent association of ADMA with PAH. The optimal cut-point of ADMA for SSc-PAH screening was determined. NT-proBNP levels were previously measured in the same patients and the optimal cut-point of NT-proBNP of ≥210ng/mL was coupled with the optimal cut-point of ADMA to create a screening model that combined the two biomarkers. RESULTS: The PAH group had significantly higher mean ADMA levels than the control group (0.76±0.14 μM versus 0.59±0.07 μM; p<0.0001). ADMA levels remained significantly associated with PAH after the adjustment for specific disease characteristics, cardiovascular risk factors and other SSc-related vascular complications (all p<0.01). An ADMA level ≥0.7 μM had a sensitivity of 86.7%, specificity of 90.0% and AUC of 0.86 for diagnosing PAH. A screening model that combined an NT-proBNP ≥210ng/mL and/ or ADMA ≥0.7 ng/mL resulted in a sensitivity of 100% and specificity of 90% for the detection of SSc-PAH. CONCLUSIONS: In this small study, use of ADMA in combination with NT-proBNP produced excellent sensitivity and specificity for the non-invasive identification of SSc-PAH. The role of ADMA as a screening biomarker for SSc-PAH merits further evaluation. |
Keywords: | Pulmonary Artery Humans Hypertension, Pulmonary Scleroderma, Systemic Natriuretic Peptide, Brain Arginine Peptide Fragments Prognosis Chromatography, High Pressure Liquid Area Under Curve Logistic Models Risk Factors Case-Control Studies Predictive Value of Tests ROC Curve Adult Middle Aged Australia Female Male Arterial Pressure Biomarkers |
Description: | Published: 13/10/2016. CER8524 |
Rights: | Copyright status unknown |
Published version: | http://www.clinexprheumatol.org/abstract.asp?a=9406 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
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