{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:54:20Z","timestamp":1772999660353,"version":"3.50.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,4,3]]},"abstract":"\n Background<\/jats:title>\n \n The endogenous amino acid homoarginine predicts mortality in cerebro\u2010 and cardiovascular disease. The objective was to explore whether homoarginine is associated with atrial fibrillation (\n AF<\/jats:styled-content>\n ) and outcome in patients with acute chest pain.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n One thousand six hundred forty\u2010nine patients with acute chest pain were consecutively enrolled in this study, of whom 589 were diagnosed acute coronary syndrome (\n ACS<\/jats:styled-content>\n ). On admission, plasma concentrations of homoarginine as well as brain natriuretic peptide (\n BNP<\/jats:styled-content>\n ), and high\u2010sensitivity assayed troponin I (hsTnI) were determined along with electrocardiography (\n ECG<\/jats:styled-content>\n ) variables. During a median follow\u2010up of 183\u00a0days, 60 major adverse cardiovascular events (\n MACEs<\/jats:styled-content>\n ; 3.8%), including all\u2010cause death, myocardial infarction, or stroke, were registered in the overall study population and 43\n MACEs<\/jats:styled-content>\n (7.5%) in the\n ACS<\/jats:styled-content>\n subgroup. Adjusted multivariable Cox regression analyses revealed that an increase of 1\n SD<\/jats:styled-content>\n of plasma log\u2010transformed homoarginine (0.37) was associated with a hazard reduction of 26% (hazard ratio [\n HR<\/jats:styled-content>\n ], 0.74; 95%\n CI<\/jats:styled-content>\n , 0.57\u20130.96) for incident\n MACE<\/jats:styled-content>\n and likewise of 35% (\n HR<\/jats:styled-content>\n , 0.65; 95%\n CI<\/jats:styled-content>\n , 0.49\u20130.88) in\n ACS<\/jats:styled-content>\n patients. In Kaplan\u2013Meier survival curves, homoarginine was predictive for patients with high\u2010sensitivity assayed troponin I (hsTnI) above 27\u00a0ng\/L (\n P<\/jats:italic>\n <0.05). Last, homoarginine was inversely associated with\n QT<\/jats:styled-content>\n c duration (\n P<\/jats:italic>\n <0.001) and prevalent\n AF<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n , 0.83; 95%\n CI<\/jats:styled-content>\n , 0.71\u20130.95).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Low plasma homoarginine was identified as a risk marker for incident\n MACEs<\/jats:styled-content>\n in patients with acute chest pain, in particular, in those with elevated hsTnI. Impaired homoarginine was associated with prevalent\n AF<\/jats:styled-content>\n . Further studies are needed to investigate the link to\n AF<\/jats:styled-content>\n and evaluate homoarginine as a therapeutic option for these patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002565","type":"journal-article","created":{"date-parts":[[2016,4,14]],"date-time":"2016-04-14T05:49:30Z","timestamp":1460612970000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Low Homoarginine Levels in the Prognosis of Patients With Acute Chest Pain"],"prefix":"10.1161","volume":"5","author":[{"given":"Dorothee","family":"Atzler","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Oxford, United Kingdom"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Baum","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of General and Interventional Cardiology, University Heart Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Ojeda","sequence":"additional","affiliation":[{"name":"Department of General and Interventional Cardiology, University Heart Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Keller","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine III, Goethe University Frankfurt, Frankfurt, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhein\/Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Cordts","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate B.","family":"Schnabel","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of General and Interventional Cardiology, University Heart Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi\u2010un","family":"Choe","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl J.","family":"Lackner","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhein\/Main, Germany"},{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg\u2010University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhein\/Main, Germany"},{"name":"Department of Medicine II, University Medical Center of the Johannes Gutenberg\u2010University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer H.","family":"B\u00f6ger","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of General and Interventional Cardiology, University Heart Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edzard","family":"Schwedhelm","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, Germany"},{"name":"Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg\u2010Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Zeller","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 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