updated 2/16/2005 4:59:38 PM ET 2005-02-16T21:59:38

Levels of a stress-related protein in the blood could give doctors a powerful new tool for deciding which patients with clogged heart arteries are most in danger and need aggressive treatment, a study found.

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This protein is yet another predictor of heart trouble, in addition to such better-known substances as cholesterol and C-reactive protein.

The Danish study, published in Thursday’s New England Journal of Medicine, focused on a substance called B-natriuretic peptide, or BNP. It is released into the blood when the heart undergoes stress.

Some doctors already test for this protein to help evaluate patients with shortness of breath who may be suffering from congestive heart disease, in which the heart does not pump well.

In this study, researchers looked at patients who were in stable condition but had clogged heart arteries, a condition that often causes chest pain known as angina.

The researchers measured the protein levels in 1,034 patients and followed their health for nine years. People with the highest protein levels were 2½ times more likely to die from any cause than those with the lowest.

If the findings are embraced, this protein could help doctors decide which patients need angioplasty or bypass surgery.

“It sort of tells you that no matter what condition you have, higher levels of these peptides are associated with worse outcomes,” said cardiologist Dr. James de Lemos, at the University of Texas Southwestern Medical Center.

The test typically costs less than $50.

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