Peptide Improves Outcomes After Myocardial Infarction

Atrial natriuretic peptide reduces infarct size, improves left ventricular ejection fraction

FRIDAY, Oct. 26 (HealthDay News) -- In patients with acute myocardial infarction undergoing reperfusion, atrial natriuretic peptide reduces infarct size and improves left ventricular ejection fraction, according to the results of a study published in the Oct. 27 issue of The Lancet.

Masafumi Kitakaze, M.D., from the National Cardiovascular Center in Osaka, Japan, and colleagues studied patients with acute myocardial infarction who were undergoing reperfusion in two trials. In one trial, 569 patients were randomized to intravenous atrial natriuretic peptide or placebo, and in the other trial 545 patients were randomized to intravenous nicorandil or placebo.

The researchers found that in the atrial natriuretic peptide group, total creatine kinase fell, indicating a 14.7 percent smaller infarct. After six to 12 months, the left ventricular ejection fraction also improved in the atrial natriuretic peptide group (ratio 1.05). In contrast, intravenous nicorandil had no effect on creatine kinase or left ventricular ejection fraction. Severe hypotension was more common in patients given atrial natriuretic peptide.

"Patients with acute myocardial infarction who were given atrial natriuretic peptide had lower infarct size, fewer reperfusion injuries and better outcomes than controls," Kitakaze and colleagues conclude.

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