The Effect of Acupuncture Therapy on Serum Asymmetric Dimethylarginine Levels in Patients with Chronic Coronary Syndromes

Introduction: Acupuncture has gained recognition as an alternative treatment for various medical conditions. Recent evidence supports its utility in managing chronic coronary syndromes (CCS), including symptom relief, reduced angina frequency, and decreased nitroglycerin use. This study aimed to evaluate the effect of acupuncture on serum asymmetric dimethylarginine (ADMA) levels in patients with CCS. Methods: In this prospective cross-sectional study conducted between January and October 2019, patients with CCS were recruited from cardiology and traditional/complementary medicine clinics. Patients who received 10 sessions of acupuncture comprised the Case group, with their ADMA levels measured before and after treatment. Patients who declined acupuncture formed the Control group, with their ADMA levels assessed at the same intervals. Acupoints used were primarily on the pericardial and heart meridians, notably Neiguan (PC6) and Shenmen (HT7). Results: Baseline ADMA levels were similar between the groups. However, posttreatment ADMA levels were significantly lower in the Case group [1.81 (0.80–139.04) vs. 9.46 (0.51–167.80); p = 0.019]. A significant reduction in ADMA levels was observed in the Case group following acupuncture [3.13 (0.88–189.00) vs. 1.81 (0.80–139.04); p < 0.0001], whereas no significant change occurred in the Control group compared with the Case group [7.20 (0.72–198.7) vs. 9.46 (0.51–167.80); p = 0.019]. Conclusions: Acupuncture, when combined with guideline-directed medical therapy, significantly reduced serum ADMA levels in CCS patients. This suggests its potential role in modulating endothelial function via the ADMA-nitric oxide pathway. Larger studies with long-term follow-up are warranted to confirm these findings and assess clinical applicability.