Asymmetric dimethylarginine predicts left atrial appendage thrombus in patients with non-valvular atrial fibrillation

Abstract Introduction Atrial fibrillation (AF) is associated with increased thrombo-embolic events, with thrombi most frequently located in the left atrial appendage (LAA). Asymmetric dimethylarginine (ADMA), a potent endogenous inhibitor of nitric oxide synthase, is elevated in subjects with AF. We investigated the relationship between ADMA and risk of LAA thrombus in patients with non-valvular AF. Methods and results A total of 223 consecutive patients with non-valvular AF were enrolled (63 ± 10 years, 65% male). LAA thrombus was detected in 27 subjects by transesophageal echocardiography. Serum ADMA was significantly increased (2.5 ± 0.6 μmol/L vs 1.8 ± 0.4 μmol/L, p  Conclusions Our study suggested that high ADMA was independently associated with the presence of LAA thrombus in patients with non-valvular AF.