Relationship between c-reactive protein and the asymmetric dimethylarginine-induced endothelial dysfunction pathway in vasospastic angina.

Vasospastic angina (VSA) is a special form of atherosclerotic disease. There is some evidence suggesting a relationship between inflammation and VSA. We sought to demonstrate the relationship between high-sensitivity c-reactive protein (hs-CRP), a sensitive marker of inflammation, and the asymmetric dimethylarginine (ADMA)-induced endothelial dysfunction pathway in patients with VSA. We studied 68 patients who were diagnosed with VSA with typical symptoms and had a positive hyperventilation test. We determined plasma levels of hs-CRP, ADMA, brachial flow-mediated dilation (FMD), and other biochemical parameters in these 68 VSA patients and 68 age-matched non-VSA subjects. Multivariate logistic regression indicated that hs-CRP (OR, 3.81 P < 0.001) and a history of smoking (OR, 3.06 P = 0.008) were independently associated with the incidence of VSA. Moreover, we found that CRP was directly related to ADMA (r = 0.69, P < 0.001) but inversely related to brachial FMD (r = -0.66, P < 0.001) in patients with VSA. Additionally, ADMA was inversely related to brachial FMD (r = -0.75, P < 0.001) in patients with VSA. These results indicate that there is a relationship between CRP and the ADMA-induced endothelial dysfunction pathway in patients with VSA. Anti-inflammatory agents may be a potential strategy for the treatment of endothelial dysfunction in VSA.