A test that measures blood levels
of a molecule produced by heart muscle appears to be a strong
indicator of future cardiac problems among healthy older
people, Danish researchers report.
The test for the molecule,
whose jaw-breaking name is "N-amino terminal fragment of
the prohormone brain natriuretic peptide" (NT-proBNP), revealed
information about the possibility of major heart problems
and death "beyond traditional risk factors," the scientists
said.
The findings appear in the
April 6 issue of the Journal of
the American Medical Association.
BNP is a member of a family
of molecules called natriuretic peptides that scientists
are actively researching as potential measures of heart
risk. BNP is produced by the ventricles, the blood-pumping
chambers of the heart, under conditions of stress. The Dutch
study tested for a fragment of BNP.
BNP tests now are widely
used to assess the condition of people admitted to hospitals
with life-threatening heart failure. The newly reported
study is part of a major effort to determine whether such
a test could be used for screening purposes in the general
population, along with tests for risk factors such as blood
cholesterol and C-reactive protein (CRP), a marker of inflammation.
"We are involved in many
studies to expand the use of BNP testing," said Dr. Julie
Doyle, medical director of Biosite, a San Diego biotechnology
company that marketed the first such test. "We do have ongoing
studies to look at its use for screening, but this is not
a claim that any manufacturer has made as yet."
The Danish study involved
764 people aged 50 and older, most of whom had no history
of cardiovascular problems. A five-year follow-up found
that the incidence of death or severe cardiovascular problems
was significantly higher for people whose NT-proBNP levels
were in the top 20 percent of those tested, the researchers
reported.
The results of the new study
are "essentially the same" as those of a larger 2004 study
of people in the Framingham Heart Study, said Dr. Ramchandran
S. Vasan, associate professor of medicine at the Boston
University School of Medicine, and a senior Framingham investigator.
That study tested for the entire BNP molecule.
"As it stands, this new study
adds to the strength of the evidence linking elevated BNP
levels to cardiovascular risk," Vasan said. "But I think
we need additional data before we suggest that this should
be used for screening in the general population."
The two studies shared a
general limitation, Vasan said -- they included only older,
white people. "We need a much broader sample to answer all
the questions," he said.
Some new studies about to
be reported could provide answers, Doyle said. "We have
a couple of papers that we are looking to submit that have
a seven- or eight-year follow-up," she said. "They should
be published in the next six or seven months."
Even when those study results
become available, "the data are still preliminary at this
time about what should be the screening criteria," Doyle
said. "The test looks very promising, but at this time we
don't have information on that application [screening]."