Electrocardiographic exercise testing is the most widely used non-invasive screening test for coronary artery disease (CAD); however, both positive and negative predictive values for this procedure are hampered by relatively low sensitivity and specificity, leading to significant numbers of false negative and false positive studies. We hypothesized that NT-proBNP, a Neuro hormone secreted by cardiac myocytes in the ventricular wall in response to increased wall stress, would rise as a result of exercise-induced ischemia. If this were true, the enhancement of exercise testing by analysis of this plasma biomarker may offer significant improvement in the diagnostic accuracy of this procedure
