Pulmonary vascular disease & thromboembolismCohort study
Asymmetric Dimethylarginine and N-terminal Pro-brain Natriuretic Peptide (NT-proBNP) Levels Provide Synergistic Information in Pulmonary Arterial Hypertension
- Prospective cohort study
Authors' conclusion
ADMA and NT-proBNP provide synergistic prognostic information for patients with PAH.
Study context
- Population
- Patients with pulmonary arterial hypertension on pulmonary arterial hypertension (PAH)-specific therapy, 2008–2019
- Participants
- 215 patients
- Exposure
- Decreased vs no decreased asymmetric dimethylarginine (ADMA) at follow-up
- Outcome
- Change in ADMA plasma level and its relation to disease progression and survival (PH-related mortality or lung transplantation)
- Follow-up
- At least 6 months
Main finding
As reported in the abstract
Survival (PH-related mortality or lung transplantation) · 3 and 5 years
Decreased ADMA
88%
3-year survival · 5-year survival 80%
No decrease in ADMA
72%
3-year survival · 5-year survival 53%
- Cox regression
- HR 1.27; P < 0.005
- corrected for ΔNT-proBNP
- HR 1.35; P < 0.005
- ΔADMA
- median −0.03 μmol/L; 95% CI: −0.145 to 0.0135
Observational data: associations, not effects.
Further findings
Correlation of ΔADMA with Δ mean pulmonary arterial pressure and ΔNT-proBNP
- ΔADMA vs Δ mean pulmonary arterial pressure
- rS = 0.287; P < 0.005
- ΔADMA vs ΔNT-proBNP (not significant)
- rS = 0.135; P = 0.056
Survival, decrease in both ADMA and NT-proBNP vs only 1 parameter improved
- Better survival with decreases in both ADMA and NT-proBNP
- P < 0.005
Original publication
Asymmetric Dimethylarginine and NT-proBNP Levels Provide Synergistic Information in Pulmonary Arterial Hypertension. JACC Heart Fail. Published 3 April 2024. doi:10.1016/j.jchf.2024.02.013
Summarised from the published abstract; every number is checked against it