Natriuretic peptide levels predict outcome for patients with established
heart disease, but no studies have assessed their prognostic value in healthy
individuals or in comparison with other biomarkers of cardiac risk. Kistorp
and colleaguesArticle assessed the risk of mortality and first
major cardiovascular event by baseline levels of N-terminal prohormone brain
natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and urinary albumin/creatinine
ratio in a cohort of older adults with no history of cardiovascular disease.
They found significant associations between increased baseline levels of NT-proBNP
and mortality and first cardiovascular event. These associations were stronger
than those for CRP and mortality or first cardiovascular event and were independent
of traditional risk factors. In an editorial,Article Schillinger
discusses the mechanisms of disease associated with NT-proBNP, CRP, and urinary
albumin/creatinine ratio, and their clinical utility.