Use

Asymmetric dimethylarginine (ADMA) is an independent risk factor for major adverse cardiovascular events. ADMA inhibits nitric oxide synthesis and is elevated in diseases involving endothelial dysfunction, including hypertension, hyperlipidemia, and type II diabetes mellitus. Elevated plasma ADMA confers a 4‑ to 6‑fold increased risk of subsequent cardiovascular events or mortality in patients with acute coronary syndrome, unstable angina, type II diabetes mellitus, end‑stage renal disease, coronary heart disease, and peripheral artery disease even after adjusting for LDL‑C, HDL‑C, triglycerides, creatinine, and hs‑CRP. Plasma ADMA concentrations are lowered by rosuvastatin and atorvastatin but not simvastatin, and vildagliptin added to metformin significantly reduces ADMA concentrations in type II diabetes mellitus patients. ADMA assists in assessing the likelihood of future coronary events in patients with coronary heart disease, type II diabetes mellitus, or kidney disease and in prompting intervention and assessing improvements among subjects with elevated ADMA and hypercholesterolemia or type II diabetes mellitus.