Blood Test Predicts Cardiac Events in Heart Patients

Patients in the study were divided into four quartiles depending on their natriuretic peptide (NT)-proBNP--the N-terminal fragment of the prohormone brain-type natriuretic peptide (BNP)--blood levels and followed for an average of 3.7 years each. Twenty-six percent died or had a cardiovascular event during the course of the study. The study reported that each increasing quartile was associated with a greater risk of cardiovascular events or death, ranging from 23 of 247 (annual event rate, 2.6%) in the lowest quartile to 134 of 246 (annual event rate, 19.6%) in the highest quartile. This indicated that patients in the highest quartile were 3.4 times more likely to die or have a cardiovascular event than those in the lowest. The study was published in the January 10, 2007, issue of Journal of the American Medical Association (JAMA).

"After adjusting for all other risk factors, it's clear that this marker is picking up something that we are otherwise unable to detect with standard tests such as echocardiography,” said lead author Mary Whooley, M.D., a staff physician at SFVAMC and an associate professor of medicine at the University of California, San Francisco (UCSF; USA). Dr. Whooley cautions that the NT-proBNP test is "not something that we should order on every patient who comes in for a routine checkup,” but would be most useful for patients with known coronary heart disease.

When the heart becomes overloaded, such as when the heart wall is distended by too much blood volume or damaged by lack of blood flow to the heart itself, it secretes a hormone called B-type BNP, which acts like a natural diuretic to help the heart's function return to normal. BNP is a known predictor of short- and medium-term prognosis across the spectrum of acute coronary syndromes (ACS). The N-terminal fragment of the BNP prohormone, NT-proBNP, may be an even stronger prognostic marker.



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