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SPECT and PET in ischemic heart failure Cardiac Resynchronization Therapy and Ventricular Tachyarrhythmia Burden Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure: A Report of the American College of Cardiology Solution Set Oversight Committee Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review Ambulatory Inotrope Infusions in Advanced Heart Failure - A Systematic Review and Meta-Analysis Mechanical circulatory support devices in advanced heart failure: 2020 and beyond Frailty Is Intertwined With Heart Failure: Mechanisms, Prevalence, Prognosis, Assessment, and Management Phenotypic Refinement of Heart Failure in a National Biobank Facilitates Genetic Discovery
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Review Article2018 Apr;15(2):37-43.

JOURNAL：Curr Heart Fail Rep. Article Link

The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study

Ibrahim NE, Januzzi JL Jr. Keywords: Biomarkers; Clinical trials; Guidelines; Heart failure; Heart failure therapy; Natriuretic peptides

ABSTRACT

PURPOSE OF REVIEW - Biomarker-guided management of patients with chronic heart failure with reduced ejection fraction (HFrEF) remains controversial.

 

RECENT FINDINGS - Biomarkers have established roles for diagnosis and prognostication in HF. Pilot data suggested that use of natriuretic peptides might be helpful to guide HF care. The recent Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) randomized-controlled trial did not find therapy guided by NT-proBNP to be more effective than usual care in improving the primary endpoint of HF hospitalization or cardiovascular mortality amongst patients with chronic HFrEF. Patients inGUIDE-ITreceived similar care and had similar NT-proBNP lowering regardless of treatment allocation. Though biomarkers retain important standing for diagnosis and prognosis in HF, theGUIDE-ITtrial results suggest carefully managed patients may not benefit from a biomarker-guided strategy. Future studies focusing this intervention on patients treated in a more real-world setting are needed.

 

 


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