Identification of atherosclerotic risk factors provides targets for development of preventive therapies. Risk factor assessment permits evaluation of an individual's prospective risk of coronary heart disease (CHD). However, it has become apparent that traditional risk factors may not predict CHD in some patients. As a result, many individuals do not receive the benefit of intensive preventive strategies. Accordingly, considerable effort has focused on the identification of novel biomarkers to enhance risk stratification. Given its prognostic utility in heart failure and acute coronary syndrome, brain natriuretic peptide (BNP) and its amino-terminal fragment have received interest as possible biomarkers for CHD.