A study to determine the ability of plasma B-type Natriuretic Peptide signal peptide (BNP-SP) concentrations to act as a specific and early clinical biomarker of Acute Myocardial Infarction

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Early clinical detection of acute coronary syndromes (ACS) can be difficult. In particular, distinction between cardiac and non-cardiac events may entail 12-36 hours of delay whilst serial biomarker results are awaited and/or subsequent tests (such as exercise electrocardiography) are performed. We have achieved the first ever identification of a signal peptide in the circulation (B-type Natriuretic Peptide signal peptide (BNP-SP)) and show that it has potential to specifically and rapidly identify cardiac ischemia. We will measure serial BNP-SP concentrations in patients with clear documented myocardial infarction. This research has the potential to speed up diagnosis and ultimately improve outcomes for patients with acute coronary events. 50 patients presenting to the coronary care unit of Christchurch Hospital with typical chest pains (=4 hours from onset), clear evidence of ST-elevation on ECG together with a rise and fall of plasma troponin levels will be studied. Venous blood samples will be drawn at baseline (0), 0.5, 1, 2, 4, 8, 12, 24, 48 and 72 hours. For each blood sample, we will also measure standard plasma biomarkers of myocardial injury.