By Melinda Smith
Washington, DC
11 January 2007
 
watch Heart Disease Blood Test

The World Health Organization (WHO) says that cardiovascular disease causes approximately one third of all deaths worldwide (16.7 million). And those deaths are not just limited to industrialized nations.  By 2010, the WHO estimates that heart disease and stroke also will be the leading causes of death in developing countries.  But the WHO says heart disease is not always a death sentence. At least 20 million people survive heart disease and stroke every year.  And now a blood test can accurately predict a patient's chances of a heart attack. 

Many people already know what they should do to avoid a heart attack or stroke:  Stay away from foods full of saturated fat, salt and carbohydrates.  Eat more fruit and vegetables.  Exercise more.  Don't smoke.  Take a cholesterol-lowering drug.

But sometimes the odds of a future heart attack or stroke are still higher for those people who have already been diagnosed with cardiovascular disease. 

 
Thomas Gray
Sixty-four-year-old Thomas Gray has survived two heart attacks and is under regular medical care.   But his doctor, Kirsten Bibbins-Domingo, believes the more she knows about the risk, the more aggressive his treatment can be. "The things we were interested in are things like a heart attack, a stroke, heart failure or dying from your heart disease."

Dr. Bibbins-Domingo and a team of medical researchers in San Francisco, California followed the progress of at least 900 heart patients.  Their findings, published in the Journal of the American Medical Association, showed that the presence of a marker called NT-pro-BNP in the blood helps forecast a possible attack. 

 
Dr. Kirsten Bibbins-Domingo
Dr. Bibbins-Domingo says higher the marker, the greater the odds. "What we think is that the blood test that detects NT-proBNP can detect the heart that's under stress at very early stages in a way that may be missed by other types of heart tests that we routinely order."

Researchers say the blood test is only useful for those patients who already have heart disease.  Dr. Bibbins-Domingo says standard diagnostic tools, such as echocardiograms and stress tests, may not always reflect the true picture.

"...in some of these patients who otherwise had normal tests, their NT-proBNP levels were high and were predictive of having future complications," she says.

Patients in the study were followed for almost four years on average.  Those whose blood tests showed the highest percentage of the NT-proBNP marker were at least three times more likely to either have a heart attack or die from some form of heart disease. 

While the findings may be a little hard for patients like Thomas Gray to hear, they may alert his doctors to the need for targeted treatment: "I've been wondering how much longer do I have and what's the prognosis look like.  So I think it would be great to have a test like that."