PT - JOURNAL ARTICLE AU - P A Phillips AU - J Sasadeus AU - G P Hodsman AU - J Horowitz AU - A Saltups AU - C I Johnston TI - Plasma atrial natriuretic peptide in patients with acute myocardial infarction: effects of streptokinase. AID - 10.1136/hrt.61.2.139 DP - 1989 Feb 01 TA - British Heart Journal PG - 139--143 VI - 61 IP - 2 4099 - http://heart.bmj.com/content/61/2/139.short 4100 - http://heart.bmj.com/content/61/2/139.full SO - Heart1989 Feb 01; 61 AB - 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.