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Blood Test Predicts Heart Attack Risk

Protein Measurement Linked to Risk for Strokes, Heart Attack, and Heart Failure
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Protein Levels vs. Heart Risk continued...

During this time, roughly a quarter of the patients either died or had a hospitalization from a nonfatal heart attack, stroke, or heart failure event.

The annual event rate among patients with the highest NT-proBNP levels at study entry was 19.6%, compared with just 2.6% among patients with the lowest levels.

There were four times as many heart attack cases reported among patients with the highest levels of the protein compared with those with the lowest, and four times as many strokes.

But the strongest association was seen for heart failure. Eighty cases of heart failure were reported among patients with the highest NT-proBNP levels, compared with just three cases among patients with the lowest levels.

"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," says study researcher Mary Whooley, MD.

Value Unknown

While there is some suggestion that the test could prove useful for identifying heart risk in the general public, its most immediate use is for patients with established heart disease.

But even among these patients, its role in disease management is not yet clear, cardiologist Robert Bonow, MD, tells WebMD.

Bonow is chief of cardiology at Northwestern University Medical School and a former president of the American Heart Association.

"We aren't sure at this point what to do with this information once we have it," he says. "We can treat these patients [with elevated NT-proBNP] very aggressively, but we should be doing that anyway."

Bonow adds that while NT-proBNP may prove to be a useful test for asymptomatic patients with heart disease, "we don't really know this yet."

In an editorial accompanying the study, Marvin Konstam, MD, of Tufts University School of Medicine agreed that it remains to be seen if NT-proBNP will prove useful for the management of patients with heart disease.

Konstam tells WebMD that more study is needed to determine the value of such testing.

"The real home run will be when we identify a marker and an intervention to go along with it to lower risk," he says. "The best example of this is LDL, or bad, cholesterol. We not only know that LDL cholesterol is a predictor of heart risk, but we know that we can lower that risk with drugs."

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