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SIMPLE BLOOD TEST PREDICTS CARDIAC EVENTS AND
DEATHS -- VA researchers say, "This marker is
picking up something that we are unable to
detect with standard tests."
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http://www.emaxhealth.com/80/8948.html
Story below:
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Blood test predicts cardiac events and
death in heart patients
A simple blood test for the protein NT-proBNP accurately predicts the
risk of heart attack, heart failure, stroke, and death in patients with
known cardiovascular disease, according to a study led by a researcher
at the San Francisco VA Medical Center.
The study of 987 men and women with stable coronary heart disease
revealed that the higher a patient's level of NT-proBNP, the greater the
chance the patient would die or have a cardiovascular event – heart
attack, heart failure, or stroke.
"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 principal investigator
Mary Whooley, MD, a staff physician at SFVAMC and an associate professor
of medicine at the University of California, San Francisco.
The study appears in the January 10, 2007 issue of Journal of the
American Medical Association.
NT-proBNP is a marker in the blood for BNP, a hormone that "goes up
during times of cardiac stretch or stress," explains Whooley. "When the
heart wall is over-expanded by too much blood volume, or damaged by lack
of blood flow to the heart itself, BNP goes up, and NT-proBNP along with
it."
Patients in the study were divided into four quartiles depending on
their NT-proBNP 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 reports that "each increasing quartile
... was associated with a greater risk of cardiovascular events or
death." Patients in the quartile with the highest levels of the
biomarker were 3.4 times more likely to die or have a cardiovascular
event than patients in the group with the lowest levels.
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. "In
the general population, the incidence of heart disease is so low
relative to the incidence in heart disease patients that you get many
more false positive results than true positives, which really lowers the
value of the test," she says. "It's much better at predicting risk in a
population with a high incidence of heart disease."
Whooley also notes that, even among heart patients, the value of the
test is limited "because all of the therapies available to prevent
cardiovascular events should already be used among these patients. The
best it can do is help identify candidates for more aggressive therapy."
She says that one additional step for researchers is to see "whether
there are therapeutic interventions that still remain to be developed
that might prevent heart patients with elevated BNP from doing worse."
Patients in the current study were all enrolled in the Heart and Soul
Study, a multi-year prospective study of one thousand heart patients
directed by Whooley that is designed to investigate whether depression
predicts heart disease. "Because the Heart and Soul Study measures heart
disease so carefully, our data set has become extremely valuable for a
wide range of cardiovascular studies, many of which have nothing to do
with our original hypothesis," Whooley says. "This study is just one
example."
Co-authors of the current study were Kirsten Bibbins-Domingo, MD, PhD,
and Reena Gupta, MD, of UCSF and San Francisco General Hospital; Beeya
Na, of SFVAMC; Alan H.B. Wu, PhD, of UCSF and SFGH; and Nelson B.
Schiller, MD, of UCSF and SFVAMC.
The study was supported by grants from the Robert Wood Johnson
Foundation, the National Heart, Lung, and Blood Institute, and the UCSF
Research Evaluation and Allocation Committee; NT-proBNP assays were
funded by Roche Diagnostics Corporation.
The Heart and Soul study is funded by the Department of Veterans Affairs
and by grants from the National Heart, Lung, and Blood Institute, the
American Federation for Aging Research, the Robert Wood Johnson
Foundation, and the Nancy Kirwan Heart Research Fund that were
administered by the Northern California Institute for Research and
Education.
NCIRE is the largest research institute associated with a VA medical
center. Its mission is to improve the health and well-being of veterans
and the general public by supporting a world-class biomedical research
program conducted by the UCSF faculty at SFVAMC.
SFVAMC has the largest medical research program in the national VA
system, with more than 200 research scientists, all of whom are faculty
members at UCSF.
UCSF is a leading university that advances health worldwide by
conducting advanced biomedical research, educating graduate students in
the life sciences and health professions, and providing complex patient
care.
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Larry Scott
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