Plasma atrial natriuretic peptide in patients with acute myocardial infarction: effects of streptokinase.
Plasma concentrations of immunoreactive atrial natriuretic peptide (mean (SEM] were measured in 135 patients admitted to two coronary care units with myocardial infarction, ischaemic chest pain, or non-ischaemic chest pain. Concentrations were significantly higher in patients with acute myocardial infarction not treated with systemic thrombolysis (60.4 (14.3) pg/ml) than in patients with non-ischaemic chest pain (21.1 (4.3) pg/ml). Patients with ischaemic chest pain had intermediate values (39.3 (7.1) pg/ml). Patients with acute myocardial infarction treated with intravenous streptokinase had normal concentrations of plasma atrial natriuretic peptide (20.2 (3.6) pg/mg), which were significantly lower than those in patients with myocardial infarction not given streptokinase. These changes could not be explained by factors such as age, pre-existing hypertension, renal dysfunction, or cardiac failure, nor treatment other than streptokinase. Raised plasma concentrations of atrial natriuretic peptide in acute myocardial infarction may be a homoeostatic response acting to reduce atrial pressures by natriuresis, diuresis, and venodilatation. The lower concentrations of atrial natriuretic peptide in patients with acute myocardial infarction treated with streptokinase may reflect a short term beneficial haemodynamic effect of streptokinase.
Phillips
P A
PA
Department of Medicine, University of Melbourne, Austin Hospital, Heidelberg, Victoria, Australia.
Sasadeus
J
J
Hodsman
G P
GP
Horowitz
J
J
Saltups
A
A
Johnston
C I
CI
D000787:Angina Pectoris / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood*; D002637:Chest Pain / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy; D013300:Streptokinase / Q000627:therapeutic use*
D009320:Atrial Natriuretic Factor; D013300:Streptokinase