Struthers A D, Davies J
Division of Medicine & Therapeutics, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK.
QJM. 2005 Oct;98(10):765-9. doi: 10.1093/qjmed/hci111. Epub 2005 Aug 8.
A common key question in clinical medicine is whether coronary artery disease (CAD) is present in a patient. This applies not only to patients with symptomatic chest pain, but also to those at high risk of sudden unexpected death due to asymptomatic CAD, such as diabetics. In both groups of patients, it would be of great benefit if a simple blood test could identify those most likely to have CAD. Such individuals could then be selected for more definitive but more invasive tests for CAD, such as angiography, exercise testing, etc. In addition to its established role in diagnosing heart failure, it appears that BNP may fulfil this function of pre-screening for both symptomatic and asymptomatic CAD. We review the evidence for this new prospect, which has the potential to reduce cardiac deaths by using a simple blood test to better target cardioprotective strategies to those who most need them.
临床医学中一个常见的关键问题是患者是否患有冠状动脉疾病（CAD）。这不仅适用于有症状性胸痛的患者，也适用于因无症状CAD而有突然意外死亡高风险的人群，如糖尿病患者。对于这两类患者，如果一项简单的血液检测能够识别出最有可能患有CAD的人，那将大有裨益。然后可以选择这些人进行更具确定性但更具侵入性的CAD检测，如血管造影、运动测试等。除了在诊断心力衰竭方面已确立的作用外，脑钠肽（BNP）似乎还可能履行对有症状和无症状CAD进行预筛查的这一功能。我们回顾了这一新前景的证据，该前景有可能通过使用简单的血液检测，更好地将心脏保护策略靶向到最需要的人身上，从而减少心脏死亡。
