Diagnostic Value of Serum Asymmetric Dimethyl Arginine and Arginine Derivatives Levels in Distinguishing Potentially Life-Threatening Causes in Patients Presenting with Chest Pain to the Emergency Department

Abstract

Aim: Chest pain a common complaint in the emergency department, often associated with serious cardiovascular conditions such as ischemic heart disease, pulmonary embolism, and aortic aneurysm. Rapid and accurate diagnosis is crucial. Asymmetric dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, contributes to the pathogenesis of cardiovascular disease. Measuring serum ADMA and arginine levels may aid in distinguishing life-threatening conditions and in improving clinical decision-making. This study explores the diagnostic value of ADMA and arginine derivatives in patients presenting with chest pain, aiming to enhance early and effective medical intervention Materials and Methods: Blood samples were collected from each participant and analyzed for serum ADMA and arginine levels using liquid chromatography-mass spectrometry. Patients were classified based on potentially life-threatening versus benign causes of chest pain. Serum ADMA and arginine levels were compared between the patient and control groups. Results: A total of 219 participants were included in the study. For biochemical measurements, no significant differences were observed in levels of ADMA, symmetric dimethyl arginine, and NG-monomethyl-l-arginine, whereas arginine and the ratios differed significantly between groups. Conclusion: The findings offer new approaches to improve early diagnosis and treatment processes. It is anticipated that the results will determine whether the levels of ADMA and arginine can serve as clinically useful adjuncts in the management of chest pain. This could enable the rapid and accurate differentiation of potentially fatal causes, ultimately improving patient management and outcomes.