PLASMA N-TERMINAL ATRIAL-NATRIURETIC-PEPTIDE IN ACUTE MYOCARDIAL-INFARCTION

Plasma atrial natriuretic peptide (ANP) and the N-terminal (NT) fragme nt of the 126-amino acid prohormone of ANP (proANP; NT-proNP) were cor related with clinical findings in 41 patients with acute myocardial in farction and in 19 patients with angina pectoris. On admission to the hospital, the 39 patients with nonfatal infarction who subsequently ha d overt heart failure (n = 8) had plasma NT-proANP (2374 +/- 1038 pmol /L) and ANP (54 +/- 43 pmol/L) concentrations that were higher (p < 0. 01) than those in the patients who remained without or wire presented with minor signs of failure. In contrast to the relatively stable NT-p roANP levels, ANP decreased markedly during the first 24 hours in the patients who had any signs of failure. Hence the plasma levels of NT-p roANP and ANP did not go hand in hand in acute myocardial infarction, and NT-proANP appeared to be a better marker oi cardiac dysfunction th an ANP.