MONDAY, Nov. 11, 2002 (HealthDayNews) -- A simple, inexpensive blood test may help predict the survival prospects of people with certain heart conditions.
That's the conclusion of a study appearing in tomorrow's rapid access issue of Circulation: Journal of the American Heart Association.
"They're hoping that with a simple blood test, you can predict how well people are going to do after they have presented to the hospital with chest pain," says Dr. Dan Fisher, a clinical assistant professor at New York University School of Medicine in New York City.
"It's exciting to have something else to help determine patient management, especially if it's a simple blood marker, something you can check to see if you're at high risk or low risk," he adds.
Once patients with a higher likelihood of dying are identified, doctors can introduce more aggressive measures to save them.
Levels of the hormone B-type natriuretic peptide (BNP) are elevated in people with damaged hearts. When the pressure in the heart goes up (or when certain other conditions exist), BNP is released into the blood and helps get rid of excess sodium through urination.
The new blood test measures the levels of a particular fragment of this hormone, the N-terminal fragment (N-BNP). BNP has been shown to predict the future heart health of people with heart attacks or angina, but N-BNP appears to provide even better guidance.
In the new study, researchers looked at 609 patients admitted to a hospital with acute coronary syndrome, or ACS, which covers everything from angina to heart attacks.
"There's a spectrum of what chest pain could be. It could be either angina (not enough blood to the heart) or an actual heart attack and even gradations along there," Fisher says. "We call that acute coronary syndrome. ACS is essentially coming in with chest pain from the heart."
N-BNP levels were measured about three days after admission, then the patients were followed for 19 to 72 months. After 51 months, 86 patients, or 14 percent, had died. These individuals had median N-BNP levels higher than patients who had survived. After adjusting for various factors, those with the highest levels of N-BNP had twice the risk of dying as those with the lowest levels.
The blood test doesn't provide a diagnosis, but it does help doctors decide if the heart is responsible for shortness of breath.
"If you've had a heart attack or it's angina, this helps determine how likely this person is to get into trouble, regardless of the specific diagnoses within ACS," Fisher says.
Health-care personnel may decide to employ different tactics, based on the patient's N-BNP levels.
"You may manage them differently. You may get more aggressive with someone who has a high level of N-BNP," Fisher says. "This will help to risk stratify and identify who needs to get an angiogram or some kind of intervention as opposed to, 'Well, we'll treat you with medicines.' "
The few U.S. hospitals that already have the test available are using it, Fisher says. "We're still waiting to get more widespread availability in emergency rooms and hospitals."
What To Do
Visit the American Heart Association for more information on angina, heart attacks, and everything in between.
