Experimental animal studies have found that administering atrial natriuretic peptide (ANP) prior to myocardial reperfusion can reduce MI size through the activation of known prosurvival signalling pathways.41 Kitakaze et al18 translated this therapeutic approach in a large clinical study comprising 569 patients presenting with STEMI, in which administering Carperitide (an ANP analogue) at the time of PPCI was associated with a 14.7% reduction in enzymatic MI size (table 2). This evidence concerns the gene NPPA and myocardial infarction.