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A treatment that limits infarct size and improves left ventricular function after acute myocardial infarction could dramatically reduce morbidity from chronic heart failure. In a study from Japan, 1104 patients with AMI who were undergoing reperfusion therapy were enrolled in two independent prospective, randomized, single-blind trials: In one trial, patients received either intravenous atrial natriuretic peptide (ANP) at 0.025 μg/kg per minute for 3 days or placebo after reperfusion therapy; in the other, they received either IV nicorandil (0.067 mg/kg bolus followed by 1.67 μg/kg per minute for 24 hours) or placebo. Eligibility criteria were age between 20 and 70 years, chest pain duration >30 minutes, first AMI, and acute ST-segment-elev…