B-Type Natriuretic Peptides and the Promise of Improved Cardiovascular Risk Prediction

Since the discovery of the natriuretic peptides in the 1980s and their subsequent introduction into clinical laboratory testing in the 2000s, assays of B-type natri-uretic peptides (BNPs)2 have gainedwidespread accep-tance as important tools for diagnosis and risk stratifi-cation in the acute-care setting. Tests for natriuretic peptides accurately diagnose heart failure in patients presenting to emergency rooms with dyspnea (1, 2) and stratify risk in patients presenting with unstable angina or acute myocardial infarction. In some studies of stable patients, natriuretic peptides have shown strong associations with cardiovascular events, raising the possibility that their use as a screening tool in asymptomatic patients may help clinicians prevent heart attack and stroke. Such a finding would hav