Acute myocardial infarction (MI) results in activation of neurohormonal systems and increased plasma concentrations of myocardial enzymes and structural proteins. We hypothesized that plasma levels of N-terminal pro-brain natriuretic peptide (NT-BNP) would respond more vigorously after MI than those of other natriuretic peptides. We also sought to compare this response with that of the established myocardial injury markers troponin T (TnT), myoglobin and creatine kinase MB (CK-MB). We obtained multiple blood samples for measurement of atrial natriuretic peptide (ANP), N-terminal pro-ANP, brain natriuretic peptide (BNP) and NT-BNP along with CK-MB, TnT and myoglobin in 24 patients presenting to the Coronary Care Unit within 6 h of onset of MI. Multiple samples were obtained in the first 24 h, then at 72 h, 1 week, 6 weeks and 12 weeks. NT-BNP increased rapidly to peak at 24 h and exhibited greater (P<0.001) absolute increments from baseline compared with BNP and ANP, whereas NT-ANP did not change from baseline. Proportional increments in NT-BNP were also greater than those for the other natriuretic peptides (P<0.05). Natriuretic peptide levels reached their peak around 24 h, later than peak TnT, CK-MB and myoglobin (peak between 1–10 h), and NT-BNP and ANP remained elevated on average for 12 weeks. Our present results, with detailed sampling of a cohort of acute MI patients, demonstrate greater absolute and proportional increments in NT-BNP than ANP or BNP with sustained elevation of these peptides at 12 weeks.
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February 2004
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Research Article|
February 01 2004
Vigorous response in plasma N-terminal pro-brain natriuretic peptide (NT-BNP) to acute myocardial infarction
Denzil GILL;
Denzil GILL
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Timothy SEIDLER;
Timothy SEIDLER
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Richard W. TROUGHTON;
Richard W. TROUGHTON
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Timothy G. YANDLE;
Timothy G. YANDLE
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Christopher M. FRAMPTON;
Christopher M. FRAMPTON
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Mark RICHARDS;
Mark RICHARDS
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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John G. LAINCHBURY;
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
Correspondence: Dr J. G. Lainchbury (e-mail [email protected]).
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Gary NICHOLLS
Gary NICHOLLS
1Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, P.O. Box 4356, Christchurch 8001, New Zealand
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Publisher: Portland Press Ltd
Received:
April 11 2003
Revision Received:
July 03 2003
Accepted:
September 15 2003
Accepted Manuscript online:
September 15 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2004 The Biochemical Society
2004
Clin Sci (Lond) (2004) 106 (2): 135–139.
Article history
Received:
April 11 2003
Revision Received:
July 03 2003
Accepted:
September 15 2003
Accepted Manuscript online:
September 15 2003
Citation
Denzil GILL, Timothy SEIDLER, Richard W. TROUGHTON, Timothy G. YANDLE, Christopher M. FRAMPTON, Mark RICHARDS, John G. LAINCHBURY, Gary NICHOLLS; Vigorous response in plasma N-terminal pro-brain natriuretic peptide (NT-BNP) to acute myocardial infarction. Clin Sci (Lond) 1 February 2004; 106 (2): 135–139. doi: https://doi.org/10.1042/CS20030131
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