N-Terminal Fragment of the Prohormone Brain-Type Natriuretic Peptide (NT-proBNP), Cardiovascular Events, and Mortality in Patients with Stable Coronary Heart Disease

Identifying people who are at high risk for cardiovascular events (myocardial infarction, stroke or heart failure) is important so that they can benefit from preventive therapies. This study seeks to determine if a simple blood test for levels of amino terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) could help to predict cardiovascular events and death in outpatients with stable coronary heart disease.

The researchers recruited 987 outpatients with stable coronary heart disease from the Heart and Soul Study, a prospective cohort study designed to examine how psychosocial factors affect patients with coronary heart disease. Patients made a baseline study visit where researchers drew blood samples. The researchers took prognostic measurements of patients (e.g., echocardiogram, traditional clinical risk factors, ischemia). They followed the patients for a mean of 3.7 years.

Two-hundred and fifty-six patients had a cardiovascular event or died. Each increasing quartile of NT-proBNP level was associated with a greater risk of cardiovascular events or death. Adding the NT-proBNP level to standard clinical assessment significantly improved prediction of adverse cardiovascular outcomes.

Limitations of the study include the sample was mostly male, so the findings may not be generalizable to women.

The authors conclude that NT-proBNP level is a predictor of cardiovascular events among patients with stable coronary heart disease, independent of other prognostic markers. Use of a blood test for NT-proBNP level may help physicians identify patients at high risk for coronary heart disease. These patients could then be introduced to preventive therapies.