It's hoped a new blood test could be used on all patients with coronary artery disease to better predict their chance of heart attack and death.

An Australian-developed blood test could predict the long-term risk of heart attack and even death in people with severe coronary artery disease.

The test detects an enzyme called ACE2 after researchers at The Austin health and University of Melbourne showed patients with coronary artery disease who had a high levels of ACE2 circulating in the blood were more likely to die or suffer from a heart attack over a period of 10 years.

Researcher Professor Louise Burrell says the study could change clinical practice for a disease that remains the leading cause of death in Australia.

"We have come a long way in treating coronary artery disease, but certain patients continue to be at high risk of dying," Prof Burrell said.

"This new blood test helped identify such patients who may derive benefit from more aggressive treatment."

Coronary artery disease is a condition in which the heart's own blood supply is narrowed or blocked due to build-up of plaque.

It can lead to chest pain (angina), shortness of breath or a heart attack. As it progresses it may cause permanent heart damage leading to heart failure.

Researchers recruited 79 patients with coronary artery disease over the 10-year follow-up, heart failure, heart attacks and death occurred in 46 per cent of patients.

This occurred more often in those with the highest ACE2 levels, according to the findings published in journal PLOS ONE on Thursday.

Future studies are planned to investigate if more intense medical treatment in those patients will reduce the risk of death.

"If this were the case, the ACE2 blood test could be offered to all patients with coronary artery disease as part of their risk assessment," Prof Burrell said.