Protein exposes long-term risk from heart problems.

Since 2000, doctors have used elevated blood concentrations of a protein called B-type natriuretic peptide (BNP) to detect incipient heart failure in people with chest pain or other inconclusive symptoms.

BNP might also be a tool for predicting a person's risk of death, researchers report in the Dec. 14, 2005 Journal of the American Medical Association.

The team measured BNP in 4,266 patients entering hospitals with various symptoms of heart problems, retested most of them 4 months later, and followed as many patients as possible for 2 years. By that time, 230 of the patients had died.

Those patients who had BNP concentrations of more than 80 picograms per milliliter of blood at admission and at the 4-month checkup were three times as likely to die within 2 years as were patients who had BNP concentrations below 80 pg/ml over the first 4 months of the study, says study coauthor David A. Morrow, a cardiologist at Brigham and Women's Hospital in Boston.

Ideally, he says, the findings will encourage research into drugs that would offset the effects of high BNP. Meanwhile, the best options for patients with this marker are aggressive cholesterol lowering accompanied by treatment with platelet inhibitors and other standard heart disease drugs, he says.--N.S.